Beneficial effects of bilevel positive airway pressure after surgery under cardiopulmonary bypass

To support injured lungs, we have been applying bilevel positive airway pressure for adult patients undergoing surgery with cardiopulmonary bypass. Among 120 consecutive patients, 31 patients whose PaO2/FiO2 decreased to less than 180 after extubation assigned to the intermittent 15 min bilevel positive airway pressure (7.3+/-3.6 times per patient). Bilevel positive airway pressure improved oxygenation (PaO2/FiO2: 128+/-43 vs. 198+/-62, P=0.004) and allowed the patients with poor oxygenation after extubation to maintain PaO2/FiO2 levels similar to those of the patients without bilevel positive airway pressure. In conclusion, the bilevel positive airway pressure therapy after extubation was effective to improve lung oxygenation non-invasively in adult patients undergoing more invasive surgery with prolonged cardiopulmonary bypass.