Syed Aftab Haider, Aamir Furqan, Aatir Fayyaz, Mirza Ahmad Raza Baig, Suhail Ahmad Shah.
Effects of positive airway pressure ventilation during cardiopulmonary bypass on post-operative pulmonary oxygenation.
Pak Heart J Jan ;50(2):111-5.

Objective: To evaluate the impact of continuous positive airway pressure during cardiac surgery on post-operative pulmonary dysfunction after coronary artery bypass grafting. Methodology: This randomized control trial was conducted in Chaudhry Pervaiz Ellahi Institute of Cardiology, Multan from January 2016 to July 2016. All patients meeting the inclusion criteria who were planned to undergo CABG surgery using cardiopulmonary bypass were selected. Patients were randomly allocated into two groups. Group I: (CPAP group): in this group continuous positive airway pressure was continued after application of aortic cross clamp during surgery.Group II (Study group): in this group ventilation was kept stopped during the whole surgical procedure. P< 0.05 was considered significant. Results: Total of 150 patients were divided in two equal groups of 125 patients each. No significant difference between age and gender of patients in CPAP and control group was observed. Mean bypass time and cross-clamp time was also same in two groups. PaO2/FiO2 Ratio after one hour and four hour of surgery was significantly high in CPAP group as compared to Non-ventilation group with p=0.001 and 0.03 respectively. Alveolar-arterial oxygen gradient after one hour of extubation was 21.47+1.03 kPa in CPAP group versus 27.73+2.19 kPa in non-ventilation group with p=0.001. Similarly alveolar-arterial oxygen gradient after four hours of surgery was also significantly less in CPAP group 19.18+2.04 kPa versus 20.80+2.57 kPa in non-ventilation group with p=0.001. Mechanical ventilation time after surgery was also significantly less in CPAP group 5.12+1.89 hours in CPAP group versus 6.36+2.57 hours in non-ventilation group (p = 0.001). Conclusion: Application of continuous positive airway pressure (CPAP) at 10 cm of HO during cardiopulmonary bypass had a significant positive impact on post-operative pulmonary oxygenation.

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