NON-INVASIVE POSITIVE PRESSURE VENTILATION FACILITATES EARLY EXTUBATION IN POST OPERATIVE CARDIAC PATIENTS

To assess the use of NIPPV (non-invasive positive pressure ventilation) during weaning from mechanical ventilation in post-op patients in an ICU and compared this procedure with intermittent mandatory ventilation (IMV) by analyzing cardiac and respiratory parameters and complications. Methodology: A randomized clinical trial was conducted from June 2009 to July 2010 on Post- operative surgical patients that were on IMV for more than 48 hours, who failed at 30 minutes of spontaneous breathing T-piece trial (SBT). If failure occurred before the 30th minute, he/she was included in the group previously defined by random assignment. Patients in the experimental group were extubated and placed on NIPPV, whereas other patients (the control group) returned to IMV. Daily SBT was carried out thereafter in order to evaluate the possibility of extubation in control group. Results: Of 60 patients who failed T-piece trials, 30 patients were placed on NIPPV 30 on (IMV). The ages of patients in the NIPPV and IMV groups were 45.7± 18.11 and 47.10 ± 18.45 years respectively. In both groups, ventilation time before T-piece trial was 2-3 days. Patients of the NIPPV group had a shorterstay in the ICU and in the hospital i.e., 2.93 ±0.785 days versus 7.4+1.11 days for IMV group. No seriouscomplications were observed in both groups.Conclusion: The results of this study suggest that the combination of early extubation and NIPPV is a good alternative.