Effects of different PEEP levels on respiratory mechanics and oxygenation after coronary artery bypass grafting
OBJECTIVE: To compare the effects of different levels of positive end-expiratory pressure on respiratory mechanics and oxygenation indexes in the immediate postoperative period of coronary artery bypass grafting. METHODS: Randomized clinical trial in which 136 patients underwent coronary artery bypa...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Cirurgia Cardiovascular
2013-09-01
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| Series: | Brazilian Journal of Cardiovascular Surgery |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382013000300013&lng=en&tlng=en |
| _version_ | 1811324887198859264 |
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| author | Daniel Lago Borges Vinícius José da Silva Nina Marina de Albuquerque Gonçalves Costa Thiago Eduardo Pereira Baldez Natália Pereira dos Santos Ilka Mendes Lima Eduardo Durans Figuerêdo Josimary Lima da Silva Lula |
| author_facet | Daniel Lago Borges Vinícius José da Silva Nina Marina de Albuquerque Gonçalves Costa Thiago Eduardo Pereira Baldez Natália Pereira dos Santos Ilka Mendes Lima Eduardo Durans Figuerêdo Josimary Lima da Silva Lula |
| author_sort | Daniel Lago Borges |
| collection | DOAJ |
| description | OBJECTIVE: To compare the effects of different levels of positive end-expiratory pressure on respiratory mechanics and oxygenation indexes in the immediate postoperative period of coronary artery bypass grafting. METHODS: Randomized clinical trial in which 136 patients underwent coronary artery bypass grafting between January 2011 and March 2012 were divided into three groups and admitted to mechanical ventilation with different positive end-expiratory pressure levels: Group A, 5 cmH2O (n=44), Group B, 8 cmH2O (n=47) and Group C, 10 cmH2O (n=45). Data about respiratory mechanics were obtained from mechanical ventilator monitor and oxygenation indexes from arterial blood gas samples, collected twenty minutes after intensive care unit admission. Patients with chronic obstructive pulmonary disease and patients submitted to off-pump, emergency or combined operations were not included. For statistical analysis, we used Kruskal-Wallis, G and Chi-square tests, considering results significant when P<0.05. RESULTS: Groups were homogeneous in terms of demographic, clinical and surgical variables. Patients ventilated with positive end-expiratory pressure of 10 cmH2O (Group C) had best compliance (P=0.04) and airway resistance values, this, however, without statistical significance. They also had best oxygenation indexes, with statistical difference in all analyzed variables, and lower frequency of hypoxemia (P=0.03). CONCLUSION: Higher levels of positive end-expiratory pressure in immediate postoperative period of coronary artery bypass grafting improved pulmonary compliance values and increased oxygenation indexes, resulting in lower frequency of hypoxemia. |
| first_indexed | 2024-04-13T14:23:28Z |
| format | Article |
| id | doaj.art-d379c136228a4066b0ddbabfa19cf56a |
| institution | Directory Open Access Journal |
| issn | 1678-9741 |
| language | English |
| last_indexed | 2024-04-13T14:23:28Z |
| publishDate | 2013-09-01 |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| record_format | Article |
| series | Brazilian Journal of Cardiovascular Surgery |
| spelling | doaj.art-d379c136228a4066b0ddbabfa19cf56a2022-12-22T02:43:24ZengSociedade Brasileira de Cirurgia CardiovascularBrazilian Journal of Cardiovascular Surgery1678-97412013-09-0128338038510.5935/1678-9741.20130058S0102-76382013000300013Effects of different PEEP levels on respiratory mechanics and oxygenation after coronary artery bypass graftingDaniel Lago Borges0Vinícius José da Silva Nina1Marina de Albuquerque Gonçalves Costa2Thiago Eduardo Pereira Baldez3Natália Pereira dos Santos4Ilka Mendes Lima5Eduardo Durans Figuerêdo6Josimary Lima da Silva Lula7Universidade Federal do MaranhãoUniversidade Federal do MaranhãoUniversidade Federal do MaranhãoUniversidade Federal do MaranhãoUniversidade Federal do MaranhãoUniversidade Federal do MaranhãoUniversidade Federal do MaranhãoHospital São DomingosOBJECTIVE: To compare the effects of different levels of positive end-expiratory pressure on respiratory mechanics and oxygenation indexes in the immediate postoperative period of coronary artery bypass grafting. METHODS: Randomized clinical trial in which 136 patients underwent coronary artery bypass grafting between January 2011 and March 2012 were divided into three groups and admitted to mechanical ventilation with different positive end-expiratory pressure levels: Group A, 5 cmH2O (n=44), Group B, 8 cmH2O (n=47) and Group C, 10 cmH2O (n=45). Data about respiratory mechanics were obtained from mechanical ventilator monitor and oxygenation indexes from arterial blood gas samples, collected twenty minutes after intensive care unit admission. Patients with chronic obstructive pulmonary disease and patients submitted to off-pump, emergency or combined operations were not included. For statistical analysis, we used Kruskal-Wallis, G and Chi-square tests, considering results significant when P<0.05. RESULTS: Groups were homogeneous in terms of demographic, clinical and surgical variables. Patients ventilated with positive end-expiratory pressure of 10 cmH2O (Group C) had best compliance (P=0.04) and airway resistance values, this, however, without statistical significance. They also had best oxygenation indexes, with statistical difference in all analyzed variables, and lower frequency of hypoxemia (P=0.03). CONCLUSION: Higher levels of positive end-expiratory pressure in immediate postoperative period of coronary artery bypass grafting improved pulmonary compliance values and increased oxygenation indexes, resulting in lower frequency of hypoxemia.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382013000300013&lng=en&tlng=enRespiração com pressão positivaMecânica respiratóriaOxigenaçãoRevascularização miocárdica |
| spellingShingle | Daniel Lago Borges Vinícius José da Silva Nina Marina de Albuquerque Gonçalves Costa Thiago Eduardo Pereira Baldez Natália Pereira dos Santos Ilka Mendes Lima Eduardo Durans Figuerêdo Josimary Lima da Silva Lula Effects of different PEEP levels on respiratory mechanics and oxygenation after coronary artery bypass grafting Brazilian Journal of Cardiovascular Surgery Respiração com pressão positiva Mecânica respiratória Oxigenação Revascularização miocárdica |
| title | Effects of different PEEP levels on respiratory mechanics and oxygenation after coronary artery bypass grafting |
| title_full | Effects of different PEEP levels on respiratory mechanics and oxygenation after coronary artery bypass grafting |
| title_fullStr | Effects of different PEEP levels on respiratory mechanics and oxygenation after coronary artery bypass grafting |
| title_full_unstemmed | Effects of different PEEP levels on respiratory mechanics and oxygenation after coronary artery bypass grafting |
| title_short | Effects of different PEEP levels on respiratory mechanics and oxygenation after coronary artery bypass grafting |
| title_sort | effects of different peep levels on respiratory mechanics and oxygenation after coronary artery bypass grafting |
| topic | Respiração com pressão positiva Mecânica respiratória Oxigenação Revascularização miocárdica |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382013000300013&lng=en&tlng=en |
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