Use of Lung Opening Maneuver in Patients with Acute Respiratory Failure After Cardiosurgical Operations

Еременко, А А; Левиков, Д. И.; Egorov, V M; Зорин, Д. Е.; Борисов, Р. Ю.

doi:10.15360/1813-9779-2006-1-23-28

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…In the first studies in the field, a high success rate, up to 90%, was noted, especially among the subjects with mild-to-moderate hypoxemic respiratory failure. [25][26][27] These data were in agreement with our study, in which the majority of the subjects with acute respiratory failure were successfully treated with NIV. However, recent studies have failed to confirm this finding, with NIV failure rates ranging from 21.9% to 52%.…”

Section: Discussionsupporting

confidence: 91%

Noninvasive Ventilation to Treat Respiratory Failure After Cardiac Surgery: Predictors of Application and Outcome

et al. 2019

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BACKGROUND: Respiratory complications remain a major cause of morbidity in cardiac surgery patients. This study aimed to determine the prognostic parameters associated with the application of noninvasive ventilation (NIV) for the treatment of acute respiratory failure, along with the possible predictors associated with NIV failure, among the subjects who underwent cardiac surgery. METHODS: This was a retrospective cohort study. Data on all adult patients who underwent cardiac surgery in a single center between May 2012 and December 2016 were analyzed. Multivariate regression analysis with bootstrapping was used to identify which baseline and intraoperative parameters were associated with the application of NIV to treat acute postoperative respiratory failure. A univariate analysis was also applied to identify potential variables associated with NIV failure. P < .05 was considered significant. RESULTS: A total of 1,657 subjects (mean ؎ SD age 65.2 ؎ 10.7 y; 21.7% females) constituted the study population, 145 (8.8%) of whom were treated with NIV due to acute postoperative respiratory failure. Body mass index adjusted odds ratio 1.02, bias-corrected 95% CI 1.01-1.04), EuroSCORE (European System for Cardiac Operative Risk Evaluation) II (adjusted odds ratio 1.11, bias-corrected 95% CI 1.02-1.32), COPD (adjusted odds ratio 4.004, bias-corrected 95% CI 2.53-8.93), and preoperative estimated glomerular filtration rate (adjusted odds ratio 0.99, bias-corrected 95% CI 0.98-0.99) independently predicted NIV application. NIV treatment failed in 16 of the 145 subjects (11%) and age, EuroSCORE II, COPD, heart failure, renal replacement therapy, and postoperative stroke were all univariately associated with the outcome. CONCLUSIONS: NIV successfully treated acute respiratory failure in the vast majority of cardiac surgery subjects and COPD, EuroSCORE II, body mass index, and preoperative renal function were independently associated with its application.

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Section: Discussionsupporting

confidence: 91%

Noninvasive Ventilation to Treat Respiratory Failure After Cardiac Surgery: Predictors of Application and Outcome

et al. 2019

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Non-invasive ventilation outside the ICU for respiratory rehabilitation after on pump cardiac surgery: a prospective randomized controlled trial.

Dvoryadkin

2024

Physical and rehabilitation medicine, medical rehabilitation

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Background: сardiac surgery with cardiopulmonary bypass (CPB) is associated with a high risk of postoperative respiratory complications. Perioperative damage to the lungs due to ischemia and reperfusion, mechanical ventilation, trauma, etc., on the one hand, is a trigger for aseptic inflammation in the lungs, on the other hand, it makes compromised lungs an easy target for infection. Actively developed methods of “protecting” of the lungs, protective lungs ventilation, etc. are limited to the perioperative and “resuscitation” stages and do not exhaust the entire range of respiratory support, in particular, required in the later stages of postoperative hospitalization, which dictates the need to search for methods of respiratory rehabilitation even after transfer from the intensive care unit. Aims: evaluate the effectiveness of respiratory rehabilitation of cardiosurgical patients using non-invasive mask lung ventilation (NIMLV) performed outside the intensive care unit (ICU), compared with standard breathing exercises. Materials and methods: A prospective, randomized, single-center study included 60 patients aged 62±12 years after cardiac surgery with CPB (86±17 min) with bypass grafting of 2±1 coronary arteries, aged 62±12 years, who required mechanical lung ventilation for more than 6 hours after surgery. After transfer from the ICU, patients in the control group (n=30) underwent standard respiratory rehabilitation; patients in the main group (n=30) additionally received four sessions of NIMLV. Results: Patients in the main group had a more rapid recovery of respiratory function, which made it possible to reduce the time of postoperative hospitalization (10 (8; 15)) in comparison with the standard group (14 (13; 20)). Conclusions: The use of NIMLV outside the ICU in addition to the standard respiratory activation protocol is safe and allows you to speed up the process of respiratory rehabilitation, reduce the duration of postoperative hospitalization of patients after coronary bypass surgery.

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Use of Lung Opening Maneuver in Patients with Acute Respiratory Failure After Cardiosurgical Operations

Cited by 2 publications

References 9 publications

Noninvasive Ventilation to Treat Respiratory Failure After Cardiac Surgery: Predictors of Application and Outcome

Noninvasive Ventilation to Treat Respiratory Failure After Cardiac Surgery: Predictors of Application and Outcome

Non-invasive ventilation outside the ICU for respiratory rehabilitation after on pump cardiac surgery: a prospective randomized controlled trial.

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