NONINVASIVE POSITIVE PRESSURE VENTILATION AFTER CARDIAC SURGERY

Abstract

Background: We have reported the results obtained by non-invasive positive pressure ventilation (NIPPV)applied to the patients who had an open heart surgery and suffered from respiratory failure after extubation dueto various reasons.Materials and Methods: We applied NIPV support following severe respiratory deterioration in fifteen patients who underwent open heart surgery under cardiopulmonary bypass in our clinic between January 2000 and January 2001. Nine patients (60%) required NIPPV because of acute inflammation of underlying chronic obstructive pulmonary disease (COPD). Remaining six patients (40%) suffered from alveolar hypoventilation despite normal preoperative respiratoryfunction. Despite NIPPV support (avarage 2 to 4 hours), five patients required reentubation due to respiratoryfailure defined as persistandt hypoxia, hypercapnia and hemodynamic instability. However, respiratoryparameters improved significantly in 10 patients and reentubation was avoided.Results: Ten patients who did not require reentubation were supported by NIPPV for avarege of 8±5 hours(range 3-18 hours). One patient (6.66%) died as a result of acute respiratory distress syndrome (ARDS) followingaspiration pneumonia during the first week of postoperative period.Conclusion: NIPPV which is less invasive when compared to endotracheal entubation can be life saving.Timely application of NIPPV also prevents possible complications of endotracheal entubation in the patinetswho suffered from respiratory failure that did not require immediate entubation after open heart surgery.