Expansion Pulmonary Therapy in Blood Oxygenation and Lactate Serum Level in Postoperative Cardiac Surgery

Oliveira, Silvana Souza; Neto, Mansueto Gomes; Aras, Roque

doi:10.5935/2359-4802.20170092

Cited by 3 publications

(8 citation statements)

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“…Correlating similar studies, it was evidenced by Setak-Berenjestanaki [13] research that the use of 10 cmH2O PEEP in patients with mechanical ventilation in the ICU after CC can lead to a significant reduction in the risk rate with incidence of atelectasis taking into account alveolar recruitment and redistribution of extravascular Fisioterapia Brasil 2021;22 (6):871-880 fluid. Already in a second similar study [14] on the effect of positive pressure, it shows that the PEEP of 8 cmH2O and 5 cmH2O had no significant effect on reducing this incidence.…”

Section: Discussionmentioning

confidence: 68%

“…During the research period, 70 patients were admitted for cardiac surgery, 8 of whom were excluded because three did not understand the therapy and 4 had a medical contraindication. 58 patients were included in the study, 41 (71%) male and mean age Fisioterapia Brasil 2021;22 (6):871-880…”

Section: Resultsmentioning

confidence: 99%

“…It is used in both mechanical ventilation and spontaneous breathing patients. Pulmonary expansion technique with the use of positive pressure impacts the improvement of gas exchange, optimizing oxygenation and reducing the arterial lactate level of postoperative cardiac surgery patients [6].…”

Section: Introductionmentioning

confidence: 99%

“…Fisioterapia Brasil 2021;22 (6):871-880 (FiO2), patients were evaluated at rest and in the first postoperative day. The EPAP was performed with the patient in the armchair sedation, and an arterial blood gas analysis was collected and analyzed to verify the PaO2, PaCO2, SaO2 and PaO2/FiO2 values.…”

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confidence: 99%

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Pressão positiva expiratória das vias aéreas sobre a oxigenação e hemodinâmica em pacientes submetidos a revascularização do miocárdio

Cordeiro¹,

Andrade²,

Santos³

et al. 2022

Fisioter Bras

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Introdução: A pressão positiva expiratória nas vias aéreas (EPAP) é a aplicação de uma resistência expiratória para manter a pressão positiva nas vias aéreas e também tem sido amplamente utilizada para prevenir possíveis complicações no pós-operatório de cirurgia cardíaca. Objetivo: Descrever o comportamento da oxigenação e hemodinâmica durante o uso de EPAP em pacientes submetidos à cirurgia de revascularização do miocárdio (RM). Métodos: Estudo transversal que avaliou saturação periférica de oxigênio (SpO2), frequência cardíaca (FC), frequência respiratória (FR), pressão arterial sistólica (PAS), diastólica (PAD) e média (PAM), pressão arterial de oxigênio (PaO2), pressão arterial de dióxido de carbono (PaCO2) e índice de oxigenação calculado dividindo a PaO2 pela fração inspirada de oxigênio (FiO2), os pacientes foram avaliados em repouso, no primeiro dia de pós-operatório. A EPAP foi realizada com o paciente na sedestração da poltrona e uma gasometria arterial foi coletada e analisada para verificar os valores de PaO2, PaCO2, SaO2 e PaO2/FiO2. Foi aplicada uma resistência expiratória de 12 cmH2O por dez minutos. Imediatamente após a aplicação do EPAP, os pacientes tiveram nova análise gasométrica e a hemodinâmica analisada. Resultados: 58 pacientes, 41 (71%) do sexo masculino e com idade média de 54 ± 8 anos foram avaliados. O uso de EPAP no pós-operatório levou à melhora de todas as variáveis gasométricas, exceto PaCO2. Houve uma melhora na SaO2 (%) pré-EPAP 94 ± 3 e pós-EPAP 98 ± 2, PaO2/FiO2 pré-EPAP 279 ± 10 e pós-EPAP 346 ± 8, PaO2 (mmHg) pré-EPAP 78 ± 8 e pós-EPAP 97 ± 7. Conclusão: Concluiu-se que a aplicação do EPAP teve um impacto positivo na oxigenação em pacientes submetidos à RM sem gerar efeitos adversos na hemodinâmica.

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Section: Discussionmentioning

confidence: 68%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Pressão positiva expiratória das vias aéreas sobre a oxigenação e hemodinâmica em pacientes submetidos a revascularização do miocárdio

Cordeiro¹,

Andrade²,

Santos³

et al. 2022

Fisioter Bras

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“…The application of high PEEP (15 cmH 2 O) is associated with an improvement in the aeration of the dependent lung areas and the promotion of more effective collateral ventilation. Thus, there is an optimization of the ventilation/perfusion ratio and, consequently, an improvement in oxygenation [9] .…”

Section: Discussionmentioning

confidence: 99%

Impact of Lung Expansion Therapy Using Positive End-Expiratory Pressure in Mechanically Ventilated Patients Submitted to Coronary Artery Bypass Grafting

Cordeiro¹,

Carvalho²,

Leite³

et al. 2019

Braz J Cardiovasc Surg

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ObjectiveTo evaluate the impact of different levels of positive end-expiratory pressure (PEEP) on gas exchange in patients undergoing coronary artery bypass grafting (CABG).MethodsA randomized clinical trial was conducted with patients undergoing CABG surgery. Patients were randomized into three groups: Group 10, PEEP of 10 cmH2O; Group 12, PEEP of 12 cmH2O; and Group 15, PEEP of 15 cmH2O. After the randomization, all patients underwent gas analysis at three moments: (1) before lung expansion therapy (LET); (2) 30 minutes after LET; and (3) one hour after extubation.ResultsSixty-six patients were studied, of which 61.7% were men, with mean age of 64 ± 8.9 years. Patients allocated to Group 15 showed a significant improvement in gas exchange comparing pre- and post-expansion values (239±21 vs. 301±19, P<0,001) and the increase was maintained after extubation (278±26). Despite the use of high levels of PEEP, no significant hemodynamic change was evidenced.ConclusionIt is concluded that high levels of PEEP (15 cmH2O) are beneficial for the improvement of gas exchange in patients undergoing CABG.

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Use of positive end‐expiratory pressure (20 cmH₂O) for 60 s during elective heart surgery: A randomized clinical trial

Mafalda Fiorin,

Schneider,

Berwanger

et al. 2024

Physiotherapy Res Intl

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BackgroundAlthough lung expansion therapy with positive end‐expiratory pressure (PEEP) following heart surgery is associated with positive clinical outcomes, whether such therapy can improve oxygenation and diminish the occurrence of lung complications when performed during heart surgery with extracorporeal circulation (ECC) is not yet clear.ObjectiveAnalyze the impact of lung expansion therapy with PEEP at 20 cmH2O for 60 s during elective heart surgery.MethodsA randomized clinical trial was conducted. The experimental group (EG) (n = 27) received PEEP at 20 cmH2O for 60 s during heart surgery at the moment in which ECC was ended. No intraoperative maneuver was performed in the control group (CG) (n = 15).ResultsThe incidence of atelectasis upon hospitalization and the pre‐maneuver oxygenation index (PaO2/FiO2) were similar between the groups. A lower incidence of atelectasis in the immediate postoperative period (7.4%, p = 0.03) and shorter time on noninvasive mechanical ventilation (TNIMV) (5.78 ± 2.54, p = 0.01) were found in the EG compared with the CG.ConclusionsThe application of PEEP at 20 cmH2O for 60 s during heart surgery reduces the incidence of atelectasis in the immediate postoperative period and shortens the TNIMV. This maneuver proved to be safe, with no adverse events.

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Expansion Pulmonary Therapy in Blood Oxygenation and Lactate Serum Level in Postoperative Cardiac Surgery

Cited by 3 publications

References 0 publications

Pressão positiva expiratória das vias aéreas sobre a oxigenação e hemodinâmica em pacientes submetidos a revascularização do miocárdio

Pressão positiva expiratória das vias aéreas sobre a oxigenação e hemodinâmica em pacientes submetidos a revascularização do miocárdio

Impact of Lung Expansion Therapy Using Positive End-Expiratory Pressure in Mechanically Ventilated Patients Submitted to Coronary Artery Bypass Grafting

Use of positive end‐expiratory pressure (20 cmH₂O) for 60 s during elective heart surgery: A randomized clinical trial

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Expansion Pulmonary Therapy in Blood Oxygenation and Lactate Serum Level in Postoperative Cardiac Surgery

Cited by 3 publications

References 0 publications

Pressão positiva expiratória das vias aéreas sobre a oxigenação e hemodinâmica em pacientes submetidos a revascularização do miocárdio

Pressão positiva expiratória das vias aéreas sobre a oxigenação e hemodinâmica em pacientes submetidos a revascularização do miocárdio

Impact of Lung Expansion Therapy Using Positive End-Expiratory Pressure in Mechanically Ventilated Patients Submitted to Coronary Artery Bypass Grafting

Use of positive end‐expiratory pressure (20 cmH2O) for 60 s during elective heart surgery: A randomized clinical trial

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Use of positive end‐expiratory pressure (20 cmH₂O) for 60 s during elective heart surgery: A randomized clinical trial