Why the study?
It was unclear whether lung expansion therapy with positive end-expiratory pressure during heart surgery with extracorporeal circulation improves oxygenation and reduces lung complications.
Does applying PEEP at 20 cmH2O for 60 seconds at the end of extracorporeal circulation reduce atelectasis and time on noninvasive mechanical ventilation in patients undergoing elective heart surgery?
Does applying PEEP at 20 cmH2O for 60 seconds at the end of extracorporeal circulation reduce atelectasis and time on noninvasive mechanical ventilation in patients undergoing elective heart surgery?
Applying PEEP at 20 cmH2O for 60 seconds at the end of cardiopulmonary bypass during elective heart surgery safely reduces postoperative atelectasis and shortens the duration of noninvasive mechanical ventilation.
Intraoperative PEEP during ECC cardiac surgery may enhance oxygenation; extends postoperative evidence into the operative period.
Background Although lung expansion therapy with positive end‐expiratory pressure (PEEP) following heart surgery is associated with positive clinical outcomes, whether such therapy can improve oxygenation and diminish the occurrence of lung complications when performed during heart surgery with extracorporeal circulation (ECC) is not yet clear. Objective Analyze the impact of lung expansion therapy with PEEP at 20 cmH 2 O for 60 s during elective heart surgery. Methods A randomized clinical trial was conducted. The experimental group (EG) ( n = 27) received PEEP at 20 cmH 2 O for 60 s during heart surgery at the moment in which ECC was ended. No intraoperative maneuver was performed in the control group (CG) ( n = 15). Results The incidence of atelectasis upon hospitalization and the pre‐maneuver oxygenation index (PaO 2 /FiO 2 ) were similar between the groups. A lower incidence of atelectasis in the immediate postoperative period (7.4%, p = 0.03) and shorter time on noninvasive mechanical ventilation (T NIMV ) (5.78 ± 2.54, p = 0.01) were found in the EG compared with the CG. Conclusions The application of PEEP at 20 cmH 2 O for 60 s during heart surgery reduces the incidence of atelectasis in the immediate postoperative period and shortens the T NIMV . This maneuver proved to be safe, with no adverse events.
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Fiorin et al. (2024) studied this question.
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