Prophylactic Nasal Continuous Positive Airway Pressure Following Cardiac Surgery Protects From Postoperative Pulmonary Complications: A Prospective, Randomized, Controlled Trial in 500 Patients.

Zarbock A, Mueller E, Netzer S, Gabriel A, Feindt P, Kindgen-Milles D.

Five hundred patients scheduled for elective cardiac surgery were prospectively randomized into one of two groups, in order to determine the efficacy of prophylactic nasal CPAP (nCPAP) compared to standard treatment. The control group received standard treatment which included a 10 minute application of nCPAP every 4 hours while the study group received 6 hours of nCPAP. The results showed that prophylactic nCPAP significantly improved arterial oxygenation (PaO2/FIO2) without altering heart rate and mean arterial BP. Pulmonary complications, pneumonia, and reintubation rate, and readmission to ICU or and intermediate medical care unit were reduced in study patients compared to controls. The authors conclude from the results that noninvasive respiratory support with nCPAP is a useful tool to reduce pulmonary morbidity following elective cardiac surgery.

Chest. 2008 Nov 18 Epub ahead of print

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