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

Authors
  • Cordeiro, André Luiz Lisboa1, 2
  • Carvalho, Sarah3
  • Leite, Maria Clara3
  • Vila-Flor, André3
  • Freitas, Bruno3
  • Sousa, Lucas3
  • Oliveira, Quetla3
  • Guimarães, André Raimundo3
  • 1 Escola Bahiana de Medicina e Saúde Pública (Bahiana) Unidade Acadêmica Brotas Salvador Bahia Brazil Escola Bahiana de Medicina e Saúde Pública (Bahiana) - Unidade Acadêmica Brotas, Salvador, Bahia, Brazil. , (Brazil)
  • 2 Faculdade Nobre Feira de Santana Bahia Brazil Faculdade Nobre (FAN), Feira de Santana, Bahia, Brazil. , (Brazil)
  • 3 Instituto Nobre de Cardiologia Feira de Santana Bahia Brazil Instituto Nobre de Cardiologia (INCARDIO), Feira de Santana, Bahia, Brazil. , (Brazil)
Type
Published Article
Journal
Brazilian journal of cardiovascular surgery
Publication Date
Jan 01, 2020
Volume
34
Issue
6
Pages
699–703
Identifiers
DOI: 10.21470/1678-9741-2019-0016
PMID: 31545577
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To evaluate the impact of different levels of positive end-expiratory pressure (PEEP) on gas exchange in patients undergoing coronary artery bypass grafting (CABG). A 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. Sixty-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. It 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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