Title of article :
The prophylactic effect of different levels of positive endexpiratory pressure on the incidence rate of atelectasis after cardiac surgery: A Randomized Controlled Trial
Author/Authors :
Setak-Berenjestanaki, Mostafa Student Research Committee - Mazandaran University of Medical Sciences, Sari, Iran , Bagheri-Nesami, Masoumeh Pediatric Infectious Diseases Research Center - Mazandaran University of Medical Sciences, Sari, Iran , Gholipour Baradari, Afshin Department of Anesthesiology and Critical Care - Faculty of Medicine - Mazandaran University of Medical Sciences, Sari, Iran , Mousavinasab, Nouraddin Department of Biostatistics - Faculty of Hygiene - Mazandaran University of Medical Sciences, Sari, Iran , Ghaffari, Rahman Department of Cardiac Surgery - School of Medicine - Mazandaran University of Medical Sciences, Sari, Iran , Darbeheshti, Manijeh Department of Radiology - Mazandaran Heart Center, Sari, Iran
Abstract :
Background: The use of positive end-expiratory pressure (PEEP) can have an important role as one of the ways to prevent and treat
atelectasis, but it seems that there is still no consensus about its beneficial level. The aim of this study was to determine the effect of
different levels of PEEP on the incidence of atelectasis after heart surgery.
Methods: This is a double-blind randomized controlled trial that was adopted from a research project recorded in the Iranian Registry
of Clinical Trials. This paper is the result of a research project undertaken at Fatemeh Zahra Hospital (Mazandaran Heart Center) in
2015. 180 patients underwent open heart surgery were selected and were divided randomly into three groups: control, PEEP=8, and
PEEP=10 (60 in each group). The patients in the two PEEP8 and PEEP10 intervention groups separately received 8 cm H2O and 10
cm H2O PEEP, respectively, 30 minutes after admission to the ICU for 4 hours and then received 5 cm H2O PEEP until extubation.
Atelectasis was examined two hours after the extubation and on the third day after surgery.
Results: The incidence rates of atelectasis two hours after extubation on the first day of surgery were 22 (36.7%), 20 (33.3%) and 10
(16.7%) patients in the control, PEEP8 and PEEP10 groups, respectively. The differences were statistically significant among the three
groups (p=0.035). The incidence rates of atelectasis on the third day after surgery were 39 (65%), 36 (60%) and 21 (35%) patients in
the control, PEEP8 and PEEP10 groups, respectively. The differences were also statistically significant among the three groups
(p=0.003).
Conclusion: The use of 10 cm H2O PEEP can lead to a reduction in the incidence of atelectasis, intubation time at the ICU and
length of ICU and hospital stay. Given that this level of PEEP is effective, this method is recommended to be used in postoperative
care of patients.
Keywords :
Oxygenation indices , Hemodynamic indices , Cardiac Surgery , Atelectasis , Postoperative pulmonary complications , Positive End-Expiratory Pressure
Journal title :
Astroparticle Physics
