Use of a nasal continuous positive airway pressure mask in the treatment of postoperative atelectasis in aortocoronary bypass surgery

Pinilla, Jaime C.; Oleniuk, Fredrick H.; Tan, Leonard; Rebeyka, Ivan M.; Tanna, Nirwamp; Wilkinson, Alexander; Bharadwaj, B

doi:10.1097/00003246-199008000-00008

Cited by 91 publications

(53 citation statements)

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“…After open heart surgery CPAP has been reported to increase FRC but only during application with no carry over effect [61]. Others also report transient improvement in oxygenation in this patient group during CPAP application [62,63]. LINDNER [39] reported that FRC was improved when measured 15 min after application of CPAP in patients following abdominal surgery.…”

Section: Ef®cacymentioning

confidence: 88%

The use of positive pressure devices by physiotherapists

Denehy

Berney²

2001

Eur Respir J

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The aim of this paper is to review the indications for use by physiotherapists, such as physiological rationale and the comparative efficacy of intermittent positive pressure breathing (IPPB) and continuous positive airway pressure (CPAP). A brief discussion of nasal intermittent positive airway pressure is also included.The use of IPPB for post operative prophylaxis has not been supported in the literature. In patients with low lung volumes resulting from neuromuscular disease or spinal injury, IPPB may be useful in the acute phase to improve tidal volume and cough effectiveness.The physiological benefits of CPAP to improve lung volumes are well documented in the literature. Physiotherapists use CPAP as an intermittent application in patients with low lung volumes following surgery. It is predominantly used as a second line intervention in the presence of refractory atelectasis and poor gas exchange. It may also be indicated in other patient groups with similar physiological problems.Nasal intermittent positive airway pressure combines the beneficial effects of intermittent positive pressure breathing and continuous positive airway pressure. There have been many studies evaluating its effectiveness. These have been supportive for patients with neuromuscular disease and sleep disordered breathing, but more research is needed in patients with acute respiratory failure.

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Section: Ef®cacymentioning

confidence: 88%

The use of positive pressure devices by physiotherapists

Denehy

Berney²

2001

Eur Respir J

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“…Randomised, controlled studies of various forms of NPPV applied following cardiopulmonary bypass surgery have shown improved gas exchange and lung mechanics, and decreased extravascular lung water content, but did not modify the prevalence of atelectasis [56,57,58,59]. The impact of these effects upon relevant clinical outcomes was less clear.…”

Section: Surgical Patientsmentioning

confidence: 99%

International Consensus Conferences in Intensive Care Medicine: Non-invasive positive pressure ventilation in acute respiratory failure

Evans

2000

Intensive Care Med

243

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“…In patients undergoing lung resection, compared with conventional therapy consisting of oxygen therapy alone, the use of NPPV increased the efficiency of gas exchange, assessed by a decreased alveolar-to-arterial oxygen gradient, without noticeable effects on haemodynamics, ventilatory pattern, dead space ventilation or pleural leaks [50], although no clinical outcomes were evaluated in this study. In patients undergoing aortocoronary bypass surgery, the use of continuous positive airway pressure after weaning improved pulmonary gas exchange, but failed to modify the prevalence of postsurgical atelectasis [51]. In intubated trauma patients, noninvasive PSV delivered after extubation was as effective as invasive PSV prior to extubation in maintaining arterial blood gas levels, with excellent subjective compliance and acceptance by the patients [52].…”

Section: Noninvasive Ventilation After Intubation and Mechanical Ventmentioning

confidence: 99%

Noninvasive ventilation after intubation and mechanical ventilation

Ferrer¹,

Bernadich²,

Nava³

et al. 2002

Eur Respir J

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Patients with chronic airflow obstruction who are difficult to wean from mechanical ventilation are at increased risk of intubation-associated complications and mortality because of prolonged invasive mechanical ventilation. Noninvasive positive pressure ventilation may revert most of the pathophysiological mechanisms associated with weaning failure in these patients.Several randomized controlled trials have shown that use of noninvasive ventilation to achieve earlier extubation in difficult-to-wean patients or in patients who develop respiratory failure after apparently successful extubation can result in reduced periods of endotracheal intubation and complication rates and improved survival. However, this is not a consistent finding, and the currently available published data with outcome as the primary variable are exclusively from patients who had pre-existing lung disease. In addition, the patients were haemodynamically stable, with a normal level of consciousness, no fever and a preserved cough reflex.It remains to be seen whether noninvasive positive pressure ventilation has a role in other patient groups and situations, such as prevention of postextubation failure or unplanned extubation. The technique is, however, a useful addition to the therapeutic armamentarium for a group of patients who pose a significant clinical and economic challenge. Eur Respir J 2002; 19: 959-965.

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Use of a nasal continuous positive airway pressure mask in the treatment of postoperative atelectasis in aortocoronary bypass surgery

Cited by 91 publications

References 0 publications

The use of positive pressure devices by physiotherapists

The use of positive pressure devices by physiotherapists

International Consensus Conferences in Intensive Care Medicine: Non-invasive positive pressure ventilation in acute respiratory failure

Noninvasive ventilation after intubation and mechanical ventilation

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