Cheng Zhiguang,Yang Chuanrui,Li Dalian,Guo Jianzhong,Gao Xiang,Yang Feng.Invasive-noninvasive sequential ventilation for extubation failure after coronary artery bypass surgery[J].J Amry Med Univ (J Third Mil Med Univ),2010,32(12):1357-1359.
Cheng Zhiguang,Yang Chuanrui,Li Dalian,Guo Jianzhong,Gao Xiang,Yang Feng.Invasive-noninvasive sequential ventilation for extubation failure after coronary artery bypass surgery[J].J Amry Med Univ (J Third Mil Med Univ),2010,32(12):1357-1359.DOI:
Invasive-noninvasive sequential ventilation for extubation failure after coronary artery bypass surgery
Objective To assess the validity of non-invasive positive pressure ventilation in correcting impediments to weaning from mechanical ventilation in those patients who failed to be extubated after coronary artery bypass surgery. Methods Three hundred and sixty patients undergoing coronary artery bypass surgery during December 2005 to February 2010 were included in the study. Those patients were divided into non-invasive positive pressure ventilation group due to extubation failure (N group
n=21) and control group (C group
n=329). During noninvasive positive pressure ventilation
mean arterial pressure
heart rate
respiratory rate
arterial pH value
arterial oxygen saturation
pulmonary arterial pressure
arterial oxygen tension
oxygen/inspired oxygen fraction ratio and alveolar-arterial oxygen tension difference were measured at preoperative
8 and 0 h before noninvasive positive-pressure ventilation
and 8
16
24 and 48 h after ventilation. Results Elder age (older than 65 years)
current smoking
low arterial oxygen tension /fraction of inspired oxygen
low endogenous creatinine clearance rate
with 3 vessels involved and associated valvular disease may be the risk factors of extubation failure (P0.05). The percentages of more than 3 grafts
large blood transfusion
and appeal to ventilation during cardiopulmonary bypass in N group were much higher than those in C group (P0.05). Non-invasive positive pressure ventilation improved respiratory rate
arterial oxygen saturation
heart rate
pulmonary arterial pressure
oxygenation index
alveolararterial oxygen tension difference in N groups (P0.05). Noninvasive positivepressure ventilation had obvious efficiency on cardiogenic pulmonary edema
atelectasis and acute lung injury. There were 2 patients having lung inflammation
and one of them received reintubating. The total efficiency was 95.2% for non-invasive positive pressure ventilation. Conclusion In appropriate candidates
noninvasive positivepressure ventilation exerts favorable effects on lung function