The role of continuous positive airway pressure during weaning from mechanical ventilation in cardiac surgical patients

Anaesthesia. 1995 Aug;50(8):677-81. doi: 10.1111/j.1365-2044.1995.tb06092.x.

Abstract

We investigated the effects of providing patients with continuous positive airway pressure during a short weaning period from mechanical ventilation to extubation. Following elective primary aortocoronary bypass surgery employing cardiopulmonary bypass, 80 patients received intermittent positive pressure ventilation for 5 h. At the end of this time patients were randomly allocated to one of the following three groups for a 2 h period of spontaneous respiration prior to extubation: group CPAP0 = T-piece circuit (n = 27); group CPAP5 = 5 cmH2O of continuous positive airway pressure (n = 27); group CPAP10 = 10 cmH2O of continuous positive airway pressure (n = 26). Following extubation, pulmonary gas exchange was assessed after 1, 2, 4, and 24 h. All patients had good pre-operative lung function. There was a significant increase in the median alveolar-arterial oxygen partial pressure difference and a decrease in the oxygenation index in all three groups during the period of added inspired oxygen which persisted until 24 h post-extubation, but there were no differences between the groups. In patients with good pre-operative lung function requiring primary aortocoronary bypass surgery, the use of continuous positive airway pressure confers no advantage over a simple T-piece attachment during the short period of weaning from mechanical ventilation to extubation.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Coronary Artery Bypass
  • Female
  • Humans
  • Male
  • Middle Aged
  • Partial Pressure
  • Positive-Pressure Respiration*
  • Pulmonary Gas Exchange
  • Ventilator Weaning*