Effects of CPAP-application via nasal mask and mouth-piece on gas exchange and respiratory mechanics after cardiac surgery

Ruoff, Marcel; Koch, Manja; Bühler, Andreas; Lindner, K; Brinkmann, Alexander; Radermacher, Peter; Calzia, Enrico

doi:10.3109/tcic.11.1.29.34

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…12 – 20 We analysed data from 18 trials (1457 patients) from nine countries, published between 1978 and 2001 (table 1). 21 – 38 Three authors responded to our inquiries23 24 28: all provided supplementary information, which resulted in one additional trial being identified 22.…”

Section: Resultsmentioning

confidence: 99%

Prophylactic respiratory physiotherapy after cardiac surgery: systematic review

Pasquina

2003

BMJ

187

115

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Objective To assess whether respiratory physiotherapy prevents pulmonary complications after cardiac surgery. Data sources Searches through Medline, Embase, Cinahl, the Cochrane library, and bibliographies, for randomised trials comparing any type of prophylactic respiratory physiotherapy with another type or no intervention after cardiac surgery, with a follow up of at least two days, and reporting on respiratory outcomes. Review methods Investigators assessed trial validity independently. Information on study design, population, interventions, and end points was abstracted by one investigator and checked by the others. Results 18 trials (1457 patients) were identified. Most were of low quality. They tested physical therapy (13 trials), incentive spirometry (eight), continuous positive airway pressure (five), and intermittent positive pressure breathing (three). The maximum follow up was six days. Four trials only had a no intervention control; none showed any significant benefit of physiotherapy. Across all trials and interventions, average values postoperatively were: incidence of atelectasis, 15-98%; incidence of pneumonia, 0-20%; partial pressure of arterial oxygen per inspired oxygen fraction, 212-329 mm Hg; vital capacity, 37-72% of preoperative values; and forced expiratory volume in one second, 34-72%. No intervention showed superiority for any end point. For the most labour intensive intervention, continuous positive airway pressure, the average cost of labour for each patient day was €27 (£19; $32). Conclusions The usefulness of respiratory physiotherapy for the prevention of pulmonary complications after cardiac surgery remains unproved. Large randomised trials are needed with no intervention controls, clinically relevant end points, and reasonable follow up periods.

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Section: Resultsmentioning

confidence: 99%

Prophylactic respiratory physiotherapy after cardiac surgery: systematic review

Pasquina

2003

BMJ

187

115

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“…The improvement in gas exchange with the use of CPAP occurs because it provides sufficient oxygenation and CO 2 elimination by unloading the inspiratory muscle, maintain alveolar ventilation and, thereby, stabilizing arterial pH. In addition, CPAP allows patients to take deeper breaths with less effort so it increases the volume of gas delivered to the lung and improves gas exchange which reverse clinical abnormality resulting from hypoxemia and hypercapnia [24,25].…”

Section: Discussionmentioning

confidence: 99%

Arterial Blood Gases Response to Incentive Spirometry Versus Continuous Positive Airway Pressure breathing After Coronary Artery Bypass Graft Surgery

Kader¹,

Ashmawy²

2017

J Perioper Med

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Background: Postoperative respiratory complications such as hypoxemia and atelectasis remain important causes of mortality after CABG. Objective: The aim of this study was to compare the changes in arterial blood gases after the use of incentive spirometry (IS) with continuous positive airway pressure (CPAP) during intensive care unit period, after coronary artery bypass graft (CABG) also to provide an idea about which of them is more effective method following coronary artery bypass surgery in intensive care unit. Methods: 30 volunteer patients' (22 males and 8 females) who had coronary artery bypass surgery participated in this study and they were randomly selected from surgical department at intensive care unit (ICU) in National Heart Institute, Egypt, their ages ranged from 45 to 55 years. Participants were randomly assigned between two equal groups. Group 1 received incentive spirometry breathing training in addition to routine chest physiotherapy following CABG, while Group 2 received CPAP in addition to routine chest physiotherapy program following CABG. Results: The results obtained in this study indicated that, there was statistical significant increase PaO 2 and decrease in PaCO 2 after two hours of using incentive spirometry, which indicated long term effect of incentive spirometry. While there was no statistical significant improvement in arterial blood gases after two hours of using CPAP which indicated short term effect of CPAP (p<0.05). Conclusion: Incentive spirometry is superior to continuous positive airway pressure breathing to long term improve arterial blood gases following coronary artery bypass graft surgery.

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Effects of CPAP-application via nasal mask and mouth-piece on gas exchange and respiratory mechanics after cardiac surgery

Cited by 2 publications

References 8 publications

Prophylactic respiratory physiotherapy after cardiac surgery: systematic review

Prophylactic respiratory physiotherapy after cardiac surgery: systematic review

Arterial Blood Gases Response to Incentive Spirometry Versus Continuous Positive Airway Pressure breathing After Coronary Artery Bypass Graft Surgery

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