Non-invasive ventilation after thoracic surgery

Неинвазивная вспомогательная вентиляция легких после торакальных операций
Mukhit Dossov 1, Murat Smailov 1, Anatoliy Kolos 1, Rahim Tojiboyev 1
More Detail
1 National Scientific Medical Research Center, Astana city, Kazakhstan
J CLIN MED KAZ, Volume 2, Issue 32, pp. 43-48.
OPEN ACCESS 3302 Views 2531 Downloads
Download Full Text (PDF)

ABSTRACT

Aim: To evaluate the effectiveness and appropriateness of the non-invasive ventilation (NIV) after thoracic surgery.
Methods: We have studied 2 groups of patients: the first group included 32 patients, who in the early postoperative period were performed NIV and a second group with 30 patients who received standard therapy. The physical parameters, blood gas levels, the length of stay in the intensive care department and patient satisfaction on a visual analog scale were evaluated. NIV sessions conducted up to 3 hours immediately after extubation in CPAP mode with the following parameters: starting from PEEP 4mbar and increasing every 10 minutes for 2 mbar until 10 mbar.
Results: During NIV systolic blood pressure in the first group was lower than in the second group (p <0,05). Blood gas levels (PaO 2) and respiratory index (PaO2/FiO2) was significantly higher in the first group. NIV with PEEP to 6mbar was rated "satisfactory"  by 37.5% of patients and was rated as "good"  by 65.6% of patients. More than 90% of patients rated "excellent" NIV with PEEP 4 mbar and 6mbar. Patients of the first group was transferred from ICU to clinical ward for one hour earlier (p <0.05) than those of the second group.
Conclusions: NIV was effectively with 6mbar of PEEP in patients after thoracic surgery and improved hemodynamic and blood gas parameters.
Keywords: non-invasive ventilation, thoracic surgery, early postoperative management

CITATION

Dossov M, Smailov M, Kolos A, Tojiboyev R. Non-invasive ventilation after thoracic surgery. Journal of Clinical Medicine of Kazakhstan. 2014;2(32):43-8.

REFERENCES

  • Юревич В . М. Вспомогательная неинвазивная вентиляция легких: вчера, сегодня, завтра // Вестник интенсивной терапии. - 2013. № 2.- С.59-61.
  • Кассиль В . Л., Выжигина М . А., Лескин Г. С. Искусственная и вспомогательная вентиляция лёгких // Москва: Медицина; 2004. – 18 с .
  • Кулен Р., Гуттманн Й., Россент Р. Новые методы вспомогательной вентиляции легких // Москва: Медицина; 2004. - С.4–10.
  • Nava S., Gregoretti C. et al. Noninvasive ventilation to prevent respiratory failure after extubation in high-risk patients // Crit. Care Med.- 2005. Vol.33. – P. 2465-2470.
  • Winck J.C., Azevedo L.F., Costa–Pereira A. et al. Effi cacy and safety of non–invasive ventilation in the treatment of acute cardiogenic pulmonary edema: a systematic review and meta–analysis // Crit. Care. – 2006. Vol.2. – P. 10.
  • Кассиль В . Л. Искусственная вентиляция легких / В . Л. Кассиль. – Москва. 2001. – 14 с.
  • Основы ИВЛ / С . А. Горячев, И . А. Савин. – Москва. 2013. – 68 с .
  • Ferrer M., Esquinas A., Leon M., et al. Noninvasive ventilation in severe hypoxemic respiratory failure. A randomized clinical trial // Am. J. Respir. Crit. Care Med. – 2003. Vol.168. – P. 1438-1444.
  • Sean P. et all. CMAJ. – 2011. Vol. 183(3). – P. 195–214.
  • Еременко А . А., Левиков Д . И., Егоров В . М. и др. Использование неинвазивной масочной вентиляции легких у кардиохирургических больных с острым респираторным дистресс -синдромом // Анестезиология и реаниматология. – 2004. № 5.- С.14-17.
  • arcía-Delgado M, Navarrete I, García-Palma MJ, Colmenero M. Postoperative respiratory failure after cardiac surgery: use of noninvasive ventilation // J Cardiothorac Vasc Anesth. – 2012. Vol.26 (3). – P. 443-7.
  • Полушин Ю . С. Неинвазивная вентиляция легких в интенсивной терапии // Анестезиология и реаниматология. – 2005. № 4.- С.74-79.
  • Вартанов И . В. Применение неинвазивной вентиляции легких у больных с высокимрискомпослеоперационных кардиопульмональных осложнений // Анестезиология и реаниматология. – 2007. № 3.- С.17- 19.
  • Борисов И . А. Попов Л . В. Неинвазивная вспомогательная вентиляция легких в комплексной респираторной терапии у больных с эмболией легочных артерии // Тезисы IV Сессии МНОАР. Москва. – 2009. С. 434-435.
  • Perrin C., Jullien V., Vénissac N., Berthier F., Padovani B., Guillot F., et al. Prophylactic use of noninvasive ventilation in patients undergoing lung resection surgery // Respir Med. – 2007. Vol.101. – P. 572-8.
  • Liao G, Chen R, He J. Prophylactic use of noninvasive positive pressure ventilation in post-thoracic surgery patients: A prospective randomized control study // J Thorac Dis. – 2010. Vol. 2. – P. 205-9.