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Airway Pressure Release Ventilation Mode Improves Circulatory and Respiratory Function in Patients After Cardiopulmonary Bypass, a Randomized Trial
- Source :
- Frontiers in Physiology, Frontiers in Physiology, Vol 12 (2021)
- Publication Year :
- 2021
-
Abstract
- ImportancePostoperative pulmonary complications and cardiovascular complications are major causes of morbidity, mortality, and resource utilization in cardiac surgery patients.ObjectivesTo investigate the effects of airway pressure release ventilation (APRV) on respiration and hemodynamics in post cardiac surgery patients.Main Outcomes and MeasuresA single-center randomized control trial was performed. In total, 138 patients undergoing cardiopulmonary bypass were prospectively screened. Ultimately 39 patients met the inclusion criteria and were randomized into two groups: 19 patients were managed with pressure control ventilation (PCV) and 20 patients were managed with APRV. Respiratory mechanics after 4 h, hemodynamics within the first day, and Chest radiograph score (CRS) and blood gasses within the first three days were recorded and compared.ResultsA higher cardiac index (3.1 ± 0.7 vs. 2.8 ± 0.8 L⋅min–1⋅m2; p < 0.05), and shock volume index (35.4 ± 9.2 vs. 33.1 ± 9.7 ml m–2; p < 0.05) were also observed in the APRV group after 4 h as well as within the first day (p < 0.05). Compared to the PCV group, the PaO2/FiO2 was significantly higher after 4 h in patients of APRV group (340 ± 97 vs. 301 ± 82, p < 0.05) and within the first three days (p < 0.05) in the APRV group. CRS revealed less overall lung injury in the APRV group (p < 0.001). The duration of mechanical ventilation and ICU length of stay were not significantly (p = 0.248 and 0.424, respectively).Conclusions and RelevanceCompared to PCV, APRV may be associated with increased cardiac output improved oxygenation, and decreased lung injury in postoperative cardiac surgery patients.
- Subjects :
- medicine.medical_specialty
Physiology
medicine.medical_treatment
Cardiac index
Hemodynamics
airway pressure release ventilation
Lung injury
mechanical ventilation
law.invention
Airway pressure release ventilation
03 medical and health sciences
0302 clinical medicine
law
respiratory function
Physiology (medical)
Cardiopulmonary bypass
Medicine
QP1-981
Respiratory function
Original Research
Mechanical ventilation
business.industry
030208 emergency & critical care medicine
Cardiac surgery
030228 respiratory system
Anesthesia
business
cardiopulmonary bypass
circulatory function
Subjects
Details
- ISSN :
- 1664042X
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- Frontiers in physiology
- Accession number :
- edsair.doi.dedup.....38f76cc9ae2b12d032bc93e9d7040c53