Pulmonary Effects of Noninvasive Ventilation Combined with the Recruitment Maneuver after Cardiac Surgery

Serdar Celebi, Özge Köner, Ferdi Menda, O uz Omay, lhan Günay, Kaya Suzer, and Nahit Cakar

The authors evaluated the pulmonary effects of non-invasive ventilation (NIV) with or without a recruitment manoeuvre (RM) in a group of patients following coronary artery bypass graft surgery. Patients excluded were those with pre-existing pulmonary disease, age > 65 years, ejection fraction < 40%, BMI > 30Kg/M2 and current smokers. The study sample was divided into 4 groups; RM, RM and NIV, NIV and a control group.

NIV together with RM was associated with better oxygenation during and after mechanical ventilation while NIV either alone or together with RM showed better early pulmonary function tests and lower atelectasis scores when compared to the control group. However there was no difference between the groups in terms of; duration of mechanical ventilation, length of ICU or hospital stay.NIV combined with RM is recommended to prevent postoperative atelectasis and hypoxaemia, but lacks justification as a routine intervention as it would seem not to reduce length of ICU or hospital stay in the above sample of patients.

Anaesthesia and Analgesia 2008; 107: 614 – 619

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