A72-07 Versapap Therapy Overcoming Patient Tolerance Challenges in Coronary Artery Surgery

Introduction Patient tolerance remains a critical factor in successful positive airway pressure therapy implementation to reduce atelectasis and post operative pulmonary complications (PPCs) following cardiovascular surgery. VersaPAP therapy offers intermittent, targeted therapy that may improve patient acceptance compared to continuous modalities, but still requires education and coaching. This case demonstrates successful adaptation strategies when initial patient discomfort threatens therapy compliance. Description A 46-year-old female with myocardial bridge of the left anterior descending artery causing chronic chest pain underwent surgical sternotomy and unroofing procedure. Following extubation at 1500 hours with unresolved bilateral lower lobe atelectasis, VersaPAP therapy was initiated by respiratory therapy at 1800 and a second treatment was done at 2000 hours to reduce the progression to PPC. Initial sessions were limited to four minutes due to patient complaints of chest pain. Through patient education and coaching by the respiratory therapy team and gradual adaptation, subsequent sessions on post-operative day one at 0900, 1230, and 2000 hours were successfully completed for the full ten-minute sessions. Serial chest radiographs demonstrated marked improvement in bilateral lower lobe atelectasis. The patient was successfully transferred to the step-down unit at noon on post-operative day two. Discussion This case highlights the importance of a skilled respiratory therapy team and individualized VersaPAP implementation strategies. Initial patient intolerance due to chest pain could have resulted in therapy discontinuation and potential respiratory complications. The successful adaptation approach, involving patient education and gradual session lengthening, enabled full therapeutic benefit. The radiographic evidence of atelectasis resolution within 24-48 hours validates the clinical efficacy even with modified initial dosing. This case supports flexible VersaPAP protocols that prioritize patient comfort while maintaining therapeutic goals, potentially improving overall therapy acceptance and clinical outcomes. This abstract is funded by: None