BACKGROUND: The application of CPAP has been used to minimize postoperative pulmonary complications after lung resection surgery. The aim of this study was to quantify both the CPAP effects upon lung function and functional capacity in early postoperative lung resection, as well as to evaluate if CPAP prolongs air leak through the chest drain. METHODS: Thirty patients in the postoperative period of lung resection were allocated into 2 groups: an experimental group, consisting of 15 patients who underwent a 10 cm H 2 O CPAP, and a 15 patient control group, who performed breathing exercises. Arterial blood gas analysis, peak expiratory flow (PEF), respiratory muscle strength, spirometry, and 6-min walk test (6MWT) were assessed in the preoperative period, and repeated postoperatively on the first and on the seventh day (6MWT was repeated only on the seventh day). RESULTS: Significant increases in PEF, muscle strength, and FEV 1 between the first and seventh postoperative day were observed, both in the experimental and in the control group, whereas FVC and P aO 2 increased significantly between the first and seventh postoperative day only in the experimental group. The average loss in 6-min walk distance (6MWD) from preoperative to postoperative day 7 in the experimental group was significantly lower than in control group. When comparing the 2 groups, only 6MWD was statistically different (P < .001). There was no air leakage increase through the drain with the early use of CPAP. CONCLUSION: When compared to breathing exercises, CPAP increases the 6MWD in postoperative lung resection patients, without prolonging air leak through the chest drain.
BACKGROUND: Dynamic hyperinflation, caused by expiratory flow limitation, markedly increases resting end-expiratory lung volume (functional residual capacity) in many COPD patients. OBJECTIVE: To determine the impact and duration of impact of CPAP on hyperinflation and airway resistance in patients with stable COPD. METHODS: In a case series, 21 patients underwent CPAP at 8 cm H 2 O for 15 min, then whole-body plethysmography immediately after, and at 15 and 30 min after CPAP. RESULTS: The cohort's mean ؎ SD age was 70 ؎ 9 y, and the mean FEV 1 was 41 ؎ 8% of predicted. Residual volume, functional residual capacity, total lung capacity, the ratio of residual volume to total lung capacity, and airway resistance decreased after CPAP and did not significantly change at 15 min (P < .001), but returned to baseline at 30 min. CONCLUSIONS: In patients with severe to very severe stable COPD, CPAP reduces lung volumes and airway resistance for 15 min, but the lung volumes return to baseline by 30 min.
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