Chest
Original ResearchCardiothoracic SurgeryProphylactic Nasal Continuous Positive Airway Pressure Following Cardiac Surgery Protects From Postoperative Pulmonary Complications: A Prospective, Randomized, Controlled Trial in 500 Patients
Section snippets
Patients
The ethics committee of Heinrich Heine University of Düsseldorf approved the protocol, and written informed consent was obtained from the patients before surgery. The study was conducted in accordance with the principles outlined in the Declaration of Helsinki.
All patients electively scheduled for coronary bypass surgery or heart valve replacement were eligible to participate in the study. Patients were excluded for one of the following reasons: no consent was obtained, age < 18 years,
Results
Five hundred patients were enrolled in the study during 1 year, of whom 32 were excluded for the following reasons: rethoracotomy due to bleeding (13), perioperative left ventricular failure with catecholamine treatment (11); perioperative myocardial ischemia (3); mechanical ventilation > 18 h (3); and insufficient documentation (2).
Accordingly, 468 patients were left for analysis (Fig 1). There were no statistical differences regarding demographic and surgical procedure data between the
Discussion
Hypoxemia after cardiac surgery is a common complication15, 16 and frequently caused by the impairment of the pulmonary ventilation perfusion ratio due to atelectasis.17 Atelectatic lung areas decrease FRC and increase right-left shunt6 even after uncomplicated cardiac surgery, and nonventilated lung areas may engage up to 20% of the total lung volume17 thus causing postoperative hypoxemia.15
A variety of factors have been identified that promote atelectasis, including operation-induced trauma
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