Noninvasive Ventilation After Coronary Artery Bypass Grafting in Subjects With Left-Ventricular Dysfunction.

BACKGROUND: The use of noninvasive ventilation in patients with left-ventricular dysfunction may increase cardiac performance by decreasing inspiratory effort and left-ventricular afterload. The aim of the present study was to evaluate the acute effects of noninvasive ventilation on centralvenous ox...

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Publicado en:Respiratory Care Vol. 63; no. 7; pp. 879 - 886
Autores principales: Marcondi, Natasha O., Rocco, Isadora S., Bolzan, Douglas W., Pauletti, Hayanne O., Begot, Isis, Anjos, Natalia R., Moreira, Rita Simone L., Nasrala, Mara L., Arena, Ross, Gomes, Walter J., Guizilini, Solange
Formato: research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Jul2018
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Mary Ann Liebert, Inc.
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        10.4187/respcare.05851
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        atl: Noninvasive Ventilation After Coronary Artery Bypass Grafting in Subjects With Left-Ventricular Dysfunction.
      aug:
        au:
          Marcondi, Natasha O.
          Rocco, Isadora S.
          Bolzan, Douglas W.
          Pauletti, Hayanne O.
          Begot, Isis
          Anjos, Natalia R.
          Moreira, Rita Simone L.
          Nasrala, Mara L.
          Arena, Ross
          Gomes, Walter J.
          Guizilini, Solange
        affil: Cardiology and Cardiovascular Surgery Disciplines, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
      sug:
        subj:
          Coronary Artery Bypass
          Grafts
          Ventricular Dysfunction, Left Diagnosis
          Human
          Noninvasive Procedures
          Patient Care
          Postoperative Care
          Ventilation
          Extubation
          Cardiac Surgery
          Central Venous Pressure Physiology
          Lactates
          Tissue Perfusion
          Brazil
          Geographic Locations
          Male
          Female
          Surgery, Operative
          Positive End-Expiratory Pressure
          Middle Age
          Ventricular Ejection Fraction
          Descriptive Statistics
          Middle Aged: 45-64 years
          Male
          Female
      ab: BACKGROUND: The use of noninvasive ventilation in patients with left-ventricular dysfunction may increase cardiac performance by decreasing inspiratory effort and left-ventricular afterload. The aim of the present study was to evaluate the acute effects of noninvasive ventilation on centralvenous oxygen saturation (...) and blood lactate in subjects with left-ventricular dysfunction during the early postoperative phase of coronary artery bypass grafting. METHODS: This study included 100 subjects during the postoperative phase of elective coronary artery bypass grafting. Blood samples, at 5 time points, were collected to assess tissue perfusion markers (ie, ... and blood lactate) as follows: (1) the intraoperative period (after anesthesia induction); (2) 20 min after ICU arrival, under intermittent mandatory ventilation; (3) 20 min after extubation with spontaneous breathing; (4) after 1 h of noninvasive ventilation; and (5) 20 min after discontinuation of noninvasive ventilation. RESULTS: A significant increase in the blood lactate and a drop in the ... were observed on arrival to the ICU compared with intraoperative values (P < .001). After extubation, during spontaneous breathing, the ... significantly decreased (P = .02), whereas the blood lactate increased, although not significantly (P = .21) compared with intermittent mandatory ventilation on arrival to the ICU. During the application of noninvasive ventilation, the ... significantly increased (P = .048) and the blood lactate significantly decreased (P = .008) compared with spontaneous breathing values after extubation. After noninvasive ventilation discontinuation, the ... and blood lactate did not change compared with measures taken during noninvasive ventilation; higher values of ... were maintained compared with those obtained after extubation (P < .001). CONCLUSIONS: The acute application of noninvasive ventilation improved ... and decreased the blood lactate in subjects with left-ventricular dysfunction during the early postoperative phase after coronary artery bypass grafting.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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