Efficiency of Noninvasive Ventilation in Acute Heart Failure
Objective: to evaluate the efficiency of noninvasive supporting ventilation in patients with acute cardiorespiratory failure in the early postoperative period after cardiac surgery under extracorporeal circulation. Methods. Case histories of patients operated on the heart under extracorporeal circul...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
2008-06-01
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| Series: | Общая реаниматология |
| Online Access: | https://www.reanimatology.com/rmt/article/view/757 |
| _version_ | 1797874341855100928 |
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| author | Z. Z. Nadiradze Yu. A. Bakhareva I. A. Karetnikov |
| author_facet | Z. Z. Nadiradze Yu. A. Bakhareva I. A. Karetnikov |
| author_sort | Z. Z. Nadiradze |
| collection | DOAJ |
| description | Objective: to evaluate the efficiency of noninvasive supporting ventilation in patients with acute cardiorespiratory failure in the early postoperative period after cardiac surgery under extracorporeal circulation. Methods. Case histories of patients operated on the heart under extracorporeal circulation, who postoperatively developed acute car-diorespiratory failure requiring repeated artificial ventilation (AV), were retrospectively studied. According to the AV mode, the patients were divided into 2 groups. Non-invasive AV was carried out in Group 1 (a study group). In Group 2 (a control group), tracheal intubation and mechanical ventilation were performed when respiratory indices deteriorated. In both groups, anesthesia was maintained without deviating from the clinically accepted protocol. The indications for extubation were routine. Following 24—72 hours after extubation, the health status of patients became worse, as manifested in decreased circulatory performance, requiring that they be switched to AV. Clinical and laboratory findings were used to define indications for AV switching. The conditions for noninvasive ventilation were the close cooperation of a patient with medical personnel, the absence of significant hyperthermia, injury, operation or facial abnormally, which excluded intimate mating. Results. Analysis of gas exchange changes suggests that there are no differences between the groups both just after surgery and within 24 postperfusion hours after extubation. When the condition deteriorated, no differences in oxygen exchange and delivery were observed in the study and control groups. In the control group, PaO2, oxygenation index, and oxygen delivery index were significantly less than those in the study group. Analysis of the duration of assisted ventilation revealed that the study group patients were on a respirator significantly less than the controls. The length of intensive care unit stay also increased greatly in Group 2. All patients with normal gas exchange parameters were transferred to a specialized unit. Complications, such as insignificant skin damages at the site of intimate mask mating, were observed in the study group, while in the control group, ventilator-associated pneumonia was seen in 3 cases. Conclusion. The present study has provided evidence that noninvasive AV may be effective in the occurrence of acute cardiorespiratory failure requiring the correction of gas exchange parameters after surgery under extracorporeal circulation. Key words: noninvasive supporting ventilation, cardiosurgery, extracorporeal circulation. |
| first_indexed | 2024-04-10T01:30:28Z |
| format | Article |
| id | doaj.art-6a57e77b81214e87ac9ce04660f5567a |
| institution | Directory Open Access Journal |
| issn | 1813-9779 2411-7110 |
| language | English |
| last_indexed | 2024-04-10T01:30:28Z |
| publishDate | 2008-06-01 |
| publisher | Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia |
| record_format | Article |
| series | Общая реаниматология |
| spelling | doaj.art-6a57e77b81214e87ac9ce04660f5567a2023-03-13T09:32:48ZengFederal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, RussiaОбщая реаниматология1813-97792411-71102008-06-014310.15360/1813-9779-2008-3-91757Efficiency of Noninvasive Ventilation in Acute Heart FailureZ. Z. NadiradzeYu. A. BakharevaI. A. KaretnikovObjective: to evaluate the efficiency of noninvasive supporting ventilation in patients with acute cardiorespiratory failure in the early postoperative period after cardiac surgery under extracorporeal circulation. Methods. Case histories of patients operated on the heart under extracorporeal circulation, who postoperatively developed acute car-diorespiratory failure requiring repeated artificial ventilation (AV), were retrospectively studied. According to the AV mode, the patients were divided into 2 groups. Non-invasive AV was carried out in Group 1 (a study group). In Group 2 (a control group), tracheal intubation and mechanical ventilation were performed when respiratory indices deteriorated. In both groups, anesthesia was maintained without deviating from the clinically accepted protocol. The indications for extubation were routine. Following 24—72 hours after extubation, the health status of patients became worse, as manifested in decreased circulatory performance, requiring that they be switched to AV. Clinical and laboratory findings were used to define indications for AV switching. The conditions for noninvasive ventilation were the close cooperation of a patient with medical personnel, the absence of significant hyperthermia, injury, operation or facial abnormally, which excluded intimate mating. Results. Analysis of gas exchange changes suggests that there are no differences between the groups both just after surgery and within 24 postperfusion hours after extubation. When the condition deteriorated, no differences in oxygen exchange and delivery were observed in the study and control groups. In the control group, PaO2, oxygenation index, and oxygen delivery index were significantly less than those in the study group. Analysis of the duration of assisted ventilation revealed that the study group patients were on a respirator significantly less than the controls. The length of intensive care unit stay also increased greatly in Group 2. All patients with normal gas exchange parameters were transferred to a specialized unit. Complications, such as insignificant skin damages at the site of intimate mask mating, were observed in the study group, while in the control group, ventilator-associated pneumonia was seen in 3 cases. Conclusion. The present study has provided evidence that noninvasive AV may be effective in the occurrence of acute cardiorespiratory failure requiring the correction of gas exchange parameters after surgery under extracorporeal circulation. Key words: noninvasive supporting ventilation, cardiosurgery, extracorporeal circulation.https://www.reanimatology.com/rmt/article/view/757 |
| spellingShingle | Z. Z. Nadiradze Yu. A. Bakhareva I. A. Karetnikov Efficiency of Noninvasive Ventilation in Acute Heart Failure Общая реаниматология |
| title | Efficiency of Noninvasive Ventilation in Acute Heart Failure |
| title_full | Efficiency of Noninvasive Ventilation in Acute Heart Failure |
| title_fullStr | Efficiency of Noninvasive Ventilation in Acute Heart Failure |
| title_full_unstemmed | Efficiency of Noninvasive Ventilation in Acute Heart Failure |
| title_short | Efficiency of Noninvasive Ventilation in Acute Heart Failure |
| title_sort | efficiency of noninvasive ventilation in acute heart failure |
| url | https://www.reanimatology.com/rmt/article/view/757 |
| work_keys_str_mv | AT zznadiradze efficiencyofnoninvasiveventilationinacuteheartfailure AT yuabakhareva efficiencyofnoninvasiveventilationinacuteheartfailure AT iakaretnikov efficiencyofnoninvasiveventilationinacuteheartfailure |