Postoperative Respiratory Failure After Cardiac Surgery: Use of Noninvasive Ventilation

García-Delgado, Manuel; Navarrete, Inés; García-Palma, Maria José; Colmenero, Manuel

doi:10.1053/j.jvca.2011.11.007

Cited by 44 publications

(37 citation statements)

References 30 publications

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“…Nevertheless, very few studies analyze the utility of NIV in the postoperative period of heart surgery in adults [2, 3] or children [14–16]. Our study is the first one to analyze NIV after heart surgery in children over a long period.…”

Section: Discussionmentioning

confidence: 99%

“…The use of mechanical ventilation in the postoperative period has an important impact on hemodynamics and clinical evolution [2, 3]. Several studies have found an association between mechanical ventilation in children after heart surgery and an increased risk of mortality, longer pediatric intensive care unit (PICU) length of stay (LOS) and greater costs [4, 5].…”

Section: Introductionmentioning

confidence: 99%

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Non-invasive mechanical ventilation after heart surgery in children

et al. 2016

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BackgroundThe purpose of the study was to analyze the characteristics and evolution of non-invasive mechanical ventilation (NIV) in the postoperative period of heart surgery in children.MethodsRetrospective observational study including all children requiring NIV after heart surgery in a single center pediatric intensive care unit (PICU) between 2001 and 2012. Demographic characteristics, ventilation parameters and outcomes were registered, comparing the first 6 years of the study with the last 6 years.Results935 children required invasive or non-invasive mechanical ventilation, of which 200 (21.4) received NIV. The median duration of NIV was 3 days. Mortality rate was 3.9%. The use of NIV increased from 13.2% in the first period to 29.2% in the second period (p <0.001). Continuous positive airway pressure (CPAP) was the most common modality of NIV (65.5%). The use of bilevel positive airway pressure mode (BIPAP) increased from 15% in the first period to 42.9% in the second period (p < 0.001). The nasopharyngeal tube was the most common interface (66%), but the use of nasal cannula increased from 3.3 to 41.4% in the second period (p < 0.001). NIV failed in 15% of patients. The mortality rate did not change, the duration of NIV decreased and the PICU length of stay increased throughout the study.ConclusionsNIV is increasingly being used in the postoperative period of heart surgery in our center with an 85% success rate and is associated with a lesser need for invasive mechanical ventilation. CPAP was the most common modality and the “nasopharyngeal tube” was the most common interface in our study although, in the latter years, the use of BIPAP and nasal cannula has increased significantly.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Non-invasive mechanical ventilation after heart surgery in children

et al. 2016

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“…Os efeitos da VNI abrangem o aumento da pressão intratorácica, da complacência pulmonar, dos níveis de oxigenação e da fração de ejeção (FE) com redução do trabalho respiratório (FERREIRA; VANDERLEI; VALENTI, 2014), das complicações pulmonares e do tempo de internação hospitalar (GARCIA-DELGADO et al, 2012;FERRER et al, 2014).…”

Section: Effect Of Non-invasive Ventilation On Myocardial Demand In Punclassified

Efeito Da Ventilação Não-Invasiva Sobre a Demanda Miocárdica No Pós-Operatório De Cirurgia Cardíaca

et al. 2017

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RESUMO:O objetivo deste estudo foi avaliar os efeitos da ventilação não invasiva ( VNI) por pressão positiva contínua nas vias aéreas (Continuos Positive Airway Pressure -CPAP) e por pressão positiva em dois níveis (Bilevel Positive Airway Pressure -BiPAP) sobre a demanda miocárdica no pós-operatório (PO) de revascularização miocárdica (RVM) e troca valvar. Analisa-se um estudo cross-over que submeteu pacientes de ambos os sexos (50 a 80 anos) à CPAP (9 cmH 2 0) e BiPAP (IPAP de 12 cmH 2 O e EPAP de 6 cmH 2 O) por 20 minutos com posterior avaliação do duplo produto (DP). Foi feito o registro da frequência cardíaca (FC) e da pressão arterial sistólica (PAS) no 1º, 10º e 20º minuto da VNI comparado através do ANOVA two-way e seguido pelo post hoc de Bonferroni. O teste t Student comparou a diferença entre os grupos (p<0,05). A amostra foi composta por 12 sujeitos com idade de 66,2±12,5 anos e índice de massa corporal de 24,3±5,0 Kg/ m 2 . Não foi evidenciada diferença no DP após aplicação do CPAP ou BiPAP (p= 0,829) nem na FC e PAS. O VNI por CPAP e BiPAP não teve repercussão significativa sobre as variáveis hemodinâmicas avaliadas, o que torna a VNI um recurso seguro para aplicação no PO de cirurgias cardíacas. PALAVRAS-CHAVE:Cirurgia Torácica; Fisioterapia; Ventilação Não Invasiva; Frequência Cardíaca. EFFECT OF NON-INVASIVE VENTILATION ON MYOCARDIAL DEMAND IN POSTOPERATIVE CARDIAC SURGERYABSTRACT: This study aims to assess the effects of non-invasive ventilation (NIV ) by continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BIPAP) on patients' myocardial demand in the postoperative (PO) of myocardial revascularization (RVM) and valve replacement. A crossover study involving patients of both genders (50-80 years) with CPAP (9 cmH 2 0) and BiPAP (IPAP of 12 cmH 2 O and EPAP of 6 cmH 2 O) during 20 minutes with posterior assessment of the double product (DP). It was made the record of heart rate (HR) and systolic pressure (SP) at the 1 st , 10 th and 20 th minute of NIV and comparing them with use of two-way ANOVA, followed by Bonferroni post hoc. The Student's t-test compared difference between groups (p <0.05). The sample had 12 subjects, with age 66,2±12,5 years and body mass index of 24,3±5,0 Kg/m 2 . There was no difference in DP after application of CPAP or BiPAP (p= 0.829), neither in HR nor SBP. The NIV by CPAP and BiPAP had no significant repercussion on the hemodynamic variables assessed, which makes NIV a safe resource for application in the PO of cardiac surgeries.

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“…Garcia-Delgado et al 34 conducted a retrospective study in 63 subjects to evaluate the use of NIV associated with respiratory failure after extubation in subjects after cardiac surgery. The median time from extubation to the NIV application was 40 hours (18 -96 hours).…”

Section: Patient Selectionmentioning

confidence: 99%

Respiratory Care Year in Review 2012: Invasive Mechanical Ventilation, Noninvasive Ventilation, and Cystic Fibrosis

2013

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SummaryFor the busy clinician, educator, or manager, it is becoming an increasing challenge to filter the literature to what is relevant to one's practice and then update one's practice based on the current evidence. The purpose of this paper is to review the recent literature related to invasive mechanical ventilation, noninvasive ventilation, and cystic fibrosis. These topics were chosen and reviewed in a manner that is most likely to have interest to the readers of RESPIRATORY CARE.

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Postoperative Respiratory Failure After Cardiac Surgery: Use of Noninvasive Ventilation

Cited by 44 publications

References 30 publications

Non-invasive mechanical ventilation after heart surgery in children

Non-invasive mechanical ventilation after heart surgery in children

Efeito Da Ventilação Não-Invasiva Sobre a Demanda Miocárdica No Pós-Operatório De Cirurgia Cardíaca

Respiratory Care Year in Review 2012: Invasive Mechanical Ventilation, Noninvasive Ventilation, and Cystic Fibrosis

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