Early extubation and weaning with bilevel positive airway pressure ventilation after cardiac surgery (Weaning with BiPAP ventilation after cardiac surgery)

Yapici, N.; Biçer, Yeşim; Çoruh, Türkan; Aykaç, Zeynep Zuhal

doi:10.1080/22201173.2008.10872565

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…BLPAP application can only be commenced on conscious, cooperative, and hemodynamically stable patients who can breathe spontaneously, have an adequate gag and cough reflex, and are able to remove the mask when required. Several studies have demonstrated beneficial effects of BLPAP in reducing pulmonary complications and overall length of hospital stay after cardiac surgery [ 109 – 111 ]. Furthermore, the prophylactic use of BLPAP after early extubation has been shown to be safe and effective [ 111 , 112 ].…”

Section: Pulmonary Protection Strategiesmentioning

confidence: 99%

“…Several studies have demonstrated beneficial effects of BLPAP in reducing pulmonary complications and overall length of hospital stay after cardiac surgery [ 109 – 111 ]. Furthermore, the prophylactic use of BLPAP after early extubation has been shown to be safe and effective [ 111 , 112 ]. A better tolerance was noted when BLPAP settings were commenced on low level and gradually adjusted to achieve the therapeutic target.…”

Section: Pulmonary Protection Strategiesmentioning

confidence: 99%

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Pulmonary Protection Strategies in Cardiac Surgery: Are We Making Any Progress?

Jaaly

Zakkar

Fiorentino

et al. 2015

Oxidative Medicine and Cellular Longevity

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Pulmonary dysfunction is a common complication of cardiac surgery. The mechanisms involved in the development of pulmonary dysfunction are multifactorial and can be related to the activation of inflammatory and oxidative stress pathways. Clinical manifestation varies from mild atelectasis to severe respiratory failure. Managing pulmonary dysfunction postcardiac surgery is a multistep process that starts before surgery and continues during both the operative and postoperative phases. Different pulmonary protection strategies have evolved over the years; however, the wide acceptance and clinical application of such techniques remain hindered by the poor level of evidence or the sample size of the studies. A better understanding of available modalities and/or combinations can result in the development of customised strategies for the different cohorts of patients with the potential to hence maximise patients and institutes benefits.

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Section: Pulmonary Protection Strategiesmentioning

confidence: 99%

Section: Pulmonary Protection Strategiesmentioning

confidence: 99%

Pulmonary Protection Strategies in Cardiac Surgery: Are We Making Any Progress?

Jaaly

Zakkar

Fiorentino

et al. 2015

Oxidative Medicine and Cellular Longevity

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Noninvasive positive-pressure ventilation as a weaning strategy for intubated adults with respiratory failure

Burns

Meade

Premji

et al. 2013

Cochrane Database of Systematic Reviews

103

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Non-invasive ventilation versus invasive weaning in critically ill adults: a systematic review and meta-analysis

Burns¹,

Stevenson

Laird

et al. 2021

Thorax

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BackgroundExtubation to non-invasive ventilation (NIV) has been investigated as a strategy to wean critically ill adults from invasive ventilation and reduce ventilator-related complications.MethodsWe searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, proceedings of four conferences and bibliographies (to June 2020) for randomised and quasi-randomised trials that compared extubation with immediate application of NIV to continued invasive weaning in intubated adults and reported mortality (primary outcome) or other outcomes. Two reviewers independently screened citations, assessed trial quality and abstracted data.ResultsWe identified 28 trials, of moderate-to-good quality, involving 2066 patients, 44.6% with chronic obstructive pulmonary disease (COPD). Non-invasive weaning significantly reduced mortality (risk ratio (RR) 0.57, 95% CI 0.44 to 0.74; high quality), weaning failures (RR 0.59, 95% CI 0.43 to 0.81; high quality), pneumonia (RR 0.30, 95% CI 0.22 to 0.41; high quality), intensive care unit (ICU) (mean difference (MD) −4.62 days, 95% CI −5.91 to −3.34) and hospital stay (MD −6.29 days, 95% CI −8.90 to −3.68). Non-invasive weaning also significantly reduced the total duration of ventilation, duration of invasive ventilation and duration of ventilation related to weaning (MD −0.57, 95% CI −1.08 to −0.07) and tracheostomy rate. Mortality, pneumonia, reintubation and ICU stay were significantly lower in trials enrolling COPD (vs mixed) populations.ConclusionNon-invasive weaning significantly reduced mortality, pneumonia and the duration of ventilation related to weaning, particularly in patients with COPD. Beneficial effects are less clear (or more careful patient selection is required) in non-COPD patients.PROSPERO registration numberCRD42020201402.

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Early extubation and weaning with bilevel positive airway pressure ventilation after cardiac surgery (Weaning with BiPAP ventilation after cardiac surgery)

Cited by 3 publications

References 16 publications

Pulmonary Protection Strategies in Cardiac Surgery: Are We Making Any Progress?

Pulmonary Protection Strategies in Cardiac Surgery: Are We Making Any Progress?

Noninvasive positive-pressure ventilation as a weaning strategy for intubated adults with respiratory failure

Non-invasive ventilation versus invasive weaning in critically ill adults: a systematic review and meta-analysis

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