The role of continuous positive airway pressure during weaning from mechanical ventilation in cardiac surgical patients
- 1 August 1995
- journal article
- clinical trial
- Published by Wiley in Anaesthesia
- Vol. 50 (8), 677-681
- https://doi.org/10.1111/j.1365-2044.1995.tb06092.x
Abstract
We investigated the effects of providing patients with continuous positive airway pressure during a short weaning period from mechanical ventilation to extubation. Following elective primary aortocoronary bypass surgery employing cardiopulmonary bypass, 80 patients received intermittent positive pressure ventilation for 5 h. At the end of this time patients were randomly allocated to one of the following three groups for a 2 h period of spontaneous respiration prior to extubation: group CPAP0 = T-piece circuit (n = 27); group CPAP5 = 5 cmH2O of continuous positive airway pressure (n = 27); group CPAP10 = 10 cmH2O of continuous positive airway pressure (n = 26). Following extubation, pulmonary gas exchange was assessed after 1, 2, 4, and 24 h. All patients had good pre-operative lung function. There was a significant increase in the median alveolar-arterial oxygen partial pressure difference and a decrease in the oxygenation index in all three groups during the period of added inspired oxygen which persisted until 24 h post-extubation, but there were no differences between the groups. In patients with good pre-operative lung function requiring primary aortocoronary bypass surgery, the use of continuous positive airway pressure confers no advantage over a simple T-piece attachment during the short period of weaning from mechanical ventilation to extubation.Keywords
This publication has 11 references indexed in Scilit:
- INFLUENCE OF CARDIAC OUTPUT ON THE CORRELATION BETWEEN MIXED VENOUS AND CENTRAL VENOUS OXYGEN SATURATIONBritish Journal of Anaesthesia, 1992
- Changes in lung function and pulmonary capillary permeability after cardiopulmonary bypassCritical Care Medicine, 1992
- Cardiac Output Response to Continuous Positive Airway Pressure in Congestive Heart FailureAmerican Review of Respiratory Disease, 1992
- Positive End-Expiratory Pressure vs T-PieceChest, 1991
- Determinants of Weaning and Survival Among Patients with COPD Who Require Mechanical Ventilation for Acute Respiratory FailureChest, 1989
- Assessment of the efficiency of pulmonary oxygenation. The choice of oxygenation indexActa Anaesthesiologica Scandinavica, 1988
- Extubation from Ambient or Expiratory Positive Airway Pressure in AdultsAnesthesiology, 1981
- Detrimental Effects of Removing End-expiratory Pressure Prior to Endotracheal ExtubationAnnals of Surgery, 1980
- POSITIVE END-EXPIRATORY PRESSURE IN WEANING PATIENTS FROM CONTROLLED VENTILATIONThe Lancet, 1975
- Airway Closure and Lung Volumes during Breathing with Maintained Airway Positive PressuresAnesthesiology, 1972