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Continuous positive airway pressure by mask in patients after coronary surgery
Author(s) -
JOUSELA I.,
RÄSÄNEN J.,
VERKKALA K.,
LAMMINEN A.,
MÄKELÄINEN A.,
NIKKI P.
Publication year - 1994
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1994.tb03899.x
Subject(s) - medicine , atelectasis , anesthesia , continuous positive airway pressure , oxygenation , artery , airway , bypass grafting , morning , arterial oxygen tension , surgery , coronary artery bypass surgery , blood pressure , lung , obstructive sleep apnea
Thirty patients who underwent coronary artery bypass grafting were randomized to receive 30% oxygen by mask either with an ambient airway pressure or with 7.4 mmHg (1 kPa) continuous positive airway pressure (CPAP) for 8 h after extubation. Arterial blood oxygen tension (Pao 2 ) decreased remarkably in the control group after extubation (from 19.2± 5.3 kPa to 12.4 ± 2.7 kPa) but less in the CPAP group (from 16.4 ± 3.3 kPa to 14.0 ± 2.1 kPa). On the second postoperative morning Pao 2 was equally low in both groups (control: 8.4 ± 1.5 kPa, CPAP: 8.9 ± 1.9 kPa). Atelectatic areas were seen with similar frequency in both groups, 17% (whole material) on the first and 50% on the second postoperative morning. Atelectasis was more common in patients with internal thoracic artery grafting and/or pleural drainage. In conclusion, CPAP therapy was well tolerated, and minimized the decrease in Pao 2 after extubation, but could not prevent the poor oxygenation or the late development of atelectatic areas on the second postoperative day.