Müller Andréa Pires, Olandoski Márcia, Macedo Rafael, Costantini Constantino, Guarita-Souza Luiz César
Hospital Costantini, Pontificia Universidade Católica do Paraná, Curitiba, PR.
Arq Bras Cardiol. 2006 Mar;86(3):232-9. doi: 10.1590/s0066-782x2006000300012. Epub 2006 Mar 30.
To compare the effect of the use of intermittent and continuous positive airway pressure in postoperative patients undergoing coronary artery bypass grafting.
This study included forty patients divided into two groups: one undergoing continuous positive airway pressure (CPAP Group), and the other undergoing intermittent pressure (Müller Resuscitator Group). The patients were evaluated in relation to the several study variables at the following time points: preoperative, 3rd, 24th, and 48th hours.
The patient groups were homogeneous in relation to the several demographic and clinical variables. The values of pO2, pCO2 and sO2 were within normal limits and no significant differences were found between the groups. Regarding respirometry, the groups showed significant differences in the tidal volume and respiratory rate at the 48th postoperative hour. Dyspnea and use of accessory muscle in postoperative assessments were found with a significantly higher frequency in patients undergoing CPAP. Patients undergoing Müller Resuscitator had a normal chest radiograph more frequently than did patients undergoing CPAP.
Both devices were shown to be able to keep pO2, pCO2, and sO2 values within normal limits. However, when the objective was pulmonary reexpansion with less imposed workload, the Müller Resuscitator was more effective because of its prompter action and consequently lower levels of dyspnea, respiratory rate (RR) and use of accessory muscle were observed.
比较间歇性和持续性气道正压通气在冠状动脉搭桥术后患者中的应用效果。
本研究纳入40例患者,分为两组:一组接受持续性气道正压通气(CPAP组),另一组接受间歇性压力通气(米勒复苏器组)。在术前、术后第3小时、第24小时和第48小时等时间点对患者的多个研究变量进行评估。
两组患者在人口统计学和临床变量方面具有同质性。两组患者的动脉血氧分压(pO2)、动脉血二氧化碳分压(pCO2)和血氧饱和度(sO2)值均在正常范围内,且两组间无显著差异。在呼吸测量方面,术后第48小时两组患者的潮气量和呼吸频率存在显著差异。在术后评估中,CPAP组患者出现呼吸困难和使用辅助呼吸肌的频率明显更高。米勒复苏器组患者胸部X线片正常的频率高于CPAP组患者。
两种设备均能使pO2、pCO2和sO2值保持在正常范围内。然而,当目标是在较少的负荷下实现肺复张时,米勒复苏器更为有效,因为其作用更快,因此观察到的呼吸困难、呼吸频率(RR)和辅助呼吸肌使用水平更低。