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References
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Cardiac surgery in the adult. 2nd ed. New York: MC Grow-Hill. 2003; 536-546.
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Lippincott Pub. 2004; 608-620.
12.Gattinoni L, Caironi P, Carlesso E. How to ventilation patient with acute lung injury and acute respiratory distress syndrome.
Curr Opin Crit Care. 2005; 11(1): 69-76.
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15.Gagnon J, Laporta D, Beique F, Langlois Y, Shrier I, Morin J. The clinical relevance of ventilation during cardiopulmonary bypass in the prevention of lung dysfunction in the postoperative period. The Canadian J Cardiology. 2007; 23-34.
: ) - ; < =% > ?@ .AB8 )
(PEEP
: %8* : ) ! #.
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! E
16.Celebi S, Koner O, Menda F, KorKut K, Suzer K, Cakar N. The pulmonary and hemodynamic effects of two different recruitment maneuvers after cardiac surgery. Anesth Analg. 2007; 104: 384-390.
17.Maisch S, Reissmann H, Fuellekrug B, Weismann D, Rutkowski T. Compliance and dead space Fraction indicate an optimal level of positive end expiratory pressure after recruitment in anesthetized patients.
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20.Loeckinger A, Kleinsasser A, Lindner KH, Margreiter J, Keller C, Hoermann C.
Continuous positive airway pressure at 10 cm/H2O during cardiopulmonary bypass improves post operative gas exchange.
Anesth Analg. 2000; 91(3): 522-527.
21.Niazi M. The effect of positive end expiratory pressure (PEEP) in the incidence of atelectasis after coronary artery bypass graft surgery. Kermaneshah: Behboud Pub.
2003; 14-21.
The effect of two different levels of positive end expiratory pressure (PEEP) in the incidence of atelectasis after coronary artery bypass graft surgery
Moradi B1,Teymouri H2, Porya A3, Khademi M*4, Ebrahimzadeh F5
1. MSc Student of Critical Care Nursing, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.
2. Associate Professor, Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran.
3. Assistant Professor, Department of Surgery, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran.
4. Assistant Professor, Department of Nursing, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran. [email protected].
5. Lecturer, Department of Biostatistics, Faculty of Public Health and Nutrition, University of Lorestan, Khorramabad, Iran.
Received: 10 April 2017 Accepted: 2 May 2017
Abstract
Background: The incidence of atelectasis after coronary artery bypass graft surgery is highly recommended due to the impact of different levels of PEEP to prevent these complications. The aim of this study was to investigate the effects of different levels of PEEP after coronary artery bypass graft surgery.
Materials and Methods: This study was performed by clinical trial. The sample size in this study was 90 patients. Non-probability sampling was conducted in consecutive patients that using a stratified block randomized to intervention and control groups (each group n = 45). In the control group of patients after surgery, upon arrival in the intensive care unit until tracheal extubation rates PEEP of 5 cm H2O received Patients in the intervention group after entering the intensive care unit for 4 hours average PEEP of 10 cm H2O received. Six hours after tracheal extubation atelectasis of the final diagnosis of chest radiographs, oxygen saturation and body temperature were used. For statistical analysis, chi- square test and t-test used.
Results: The incidence of atelectasis in the intervention group, in 7 patients were about (15.6%) in the control group, and in 16 patients were about (35.6%) which was statistically significant difference (P=
0.03). The mean arterial oxygen saturation was more higher in the intervention group rather than the control group and the difference was statistically significant (P= 0.025).
Conclusion: This study shows that the use of PEEP levels of 10 cm H2O after coronary artery bypass graft surgery can reduce the incidence of postoperative atelectasis. So, it is recommended to use this method in order to reduce the incidence of atelectasis.
Keywords: Positive end expiratory pressure (PEEP), Coronary artery bypass graft surgery (CABG), Atelectasis.
*Citation: Moradi B,Teymouri H, Porya A, Khademi M, Ebrahimzadeh F. The effect of two different levels of positive end expiratory pressure (PEEP) in the incidence of atelectasis after coronary artery bypass graft surgery. Yafte. 2017; 19(2): 82-92.
