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| Year : 2007 | Volume
: 1
| Issue : 1 | Page : 10 |
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The effect of positive pressure ventilatory patterns on post-bypass lung functions
Mohamed Essam Abdel-Meguid1, Emad El-Din Mansour2, Khaled M Abdallah1
1 Anaesthesia Department, College of Medicine, King Fahad Cardiac Center, King Saud University, Saudi Arabia
2 Consultant Cardiac Anaesthesia, King Khalid University Hospital, Saudi Arabia
Correspondence Address:
Mohamed Essam Abdel-Meguid
Anaesthesia Department, College of Medicine, King Fahad Cardiac Center, King Saud University, Riyadh
Saudi Arabia
 Source of Support: None, Conflict of Interest: None  | Check |
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Background: This study aimed at evaluating the effect of application of different patterns of positive ventilatory pressure either during or after cardiopulmonary bypass (CPB) on lung functions.
Methods: 30 patients undergoing coronary artery revascularisation under the management of CPB were randomly allocated into 3 groups. Group I (VCM) 10 patients were subjected to manual vital capacity manoeuvre (VCM) before weaning off the CPB. Group II (CPAP) 10 patients were subjected to continuous positive airway pressure (CPAP) of 10 cmH 2 O during CPB. Group III (PEEP) 10 patients were subjected to positive end expiratory pressure (PEEP) of 7 cmH 2 O after weaning off the CPB. Measurements included the PO 2 , PCO 2 , together with derived calculated parameters as the alveolar-arterial oxygen difference [P (A-a) DO2] and shunt fraction, as well as the dynamic lung compliance being recorded directly from the anaesthetic and ventilatory equipments. All readings were taken on closed chest and on FiO 2 of 0.5. Intraoperative anaesthetic and surgical data as well as postoperative extubation time and length of ICU stay were also evaluated.
Results: Statistical analysis of ventilatory parameters showed no significant differences for both PO 2 and PCO 2 in between the studied groups. Alveolar-Arterial oxygen difference mean values were comparable in the 3 studied groups. The mean values of intrapulmonary shunt fraction showed a significant difference in relation to the baseline values in Group I (VCM) and Group III (PEEP) at 30 minutes after ICU admission and 4 hours post CPB with estimated P value <0.01 and < 0.05 respectively, while in Group II (CPAP) mean values started to be significant after chest closure with a p value <0.05, but there was no significant intergroup differences with a P value > 0.01. Dynamic lung compliance mean values showed no intergroup statistical significance.
Conclusion: Maintenance of Ventilatory parameters was achieved in all the positive pressure ventilatory methods applied, either being applied during or after CPB. |
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