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研究无创通气对冠状动脉旁路移植术(CABG)术后患者血流动力学和呼吸参数的影响。

To Study the Effect of Noninvasive Ventilation on Hemodynamics and Respiratory Parameters in Postoperative CABG Patients.

作者信息

Mall Krishna Pratap, Iqbal Khalid, Gangwar Richa, Priya Vansh

机构信息

Department of Anesthesiology and Critical Care, CTVS Unit, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India.

Department of Surgery, CTVS Unit, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India.

出版信息

Anesth Essays Res. 2021 Apr-Jun;15(2):179-182. doi: 10.4103/aer.aer_83_21. Epub 2021 Nov 7.

Abstract

BACKGROUND AND AIM

Bilevel positive airway pressure (BIPAP) is emerging as a useful modality in prevention as well as the management of postoperative respiratory dysfunction in patients undergoing coronary artery bypass graft (CABG).

MATERIALS AND METHODS

A total of 50 patients who underwent CABG were managed using BIPAP during postoperative period. Acid-base gas parameters, electrolyte levels, respiratory and hemodynamic parameters, and 24 h urine output before and after BIPAP application were measured. Data were analyzed using SPSS 21.0 version. Paired ""-test was used to compare the changes in different parameters.

RESULTS

The mean age of patients was 57.72 ± 9.67 years (range: 36-85 years), majority were males (84%). Mean body mass index and mean left ventricular ejection fraction of patients were 24.26 ± 3.74 kg.m and 52.77 ± 10.26%, respectively. Mean pO, pCO and respiratory rate before BIPAP application were 90.62 ± 12.90 torr, 40.26 ± 5.39 torr, and 25.64 ± 6.21/min, respectively, which became 158.52 ± 50.43 torr, 37.77 ± 6.98 torr, and 21.78 ± 4.79/min, respectively, after BIPAP application, thus showing a significant change ( < 0.05). No significant change in other parameters was observed. No other adverse effect was noted.

CONCLUSION

BIPAP application helped in improving ventilatory parameters without any adverse impact on hemodynamics and other parameters. Its application was a safe method to prevent respiratory disturbances following cardiac surgery.

摘要

背景与目的

双水平气道正压通气(BIPAP)在冠状动脉旁路移植术(CABG)患者术后呼吸功能障碍的预防及管理中逐渐成为一种有用的模式。

材料与方法

共有50例行CABG的患者在术后使用BIPAP进行管理。测量了BIPAP应用前后的酸碱气体参数、电解质水平、呼吸和血流动力学参数以及24小时尿量。使用SPSS 21.0版本进行数据分析。采用配对t检验比较不同参数的变化。

结果

患者的平均年龄为57.72±9.67岁(范围:36 - 85岁),大多数为男性(84%)。患者的平均体重指数和平均左心室射血分数分别为24.26± 3.74kg/m²和52.77±10.26%。BIPAP应用前的平均pO₂、pCO₂和呼吸频率分别为90.62±12.90托、40.26±5.39托和25.64±6.21次/分钟,应用BIPAP后分别变为158.52±50.43托、37.77±6.98托和21.78±4.79次/分钟,显示出显著变化(P<0.05)。未观察到其他参数有显著变化。未发现其他不良反应。

结论

BIPAP的应用有助于改善通气参数,而对血流动力学和其他参数无任何不良影响。其应用是预防心脏手术后呼吸紊乱的一种安全方法。

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The role of noninvasive ventilation: CPAP and BiPAP in the treatment of congestive heart failure.
Dimens Crit Care Nurs. 2006 Mar-Apr;25(2):66-70. doi: 10.1097/00003465-200603000-00006.

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