Respiratory tactics during cardiopulmonary bypass in cardiac surgery
https://doi.org/10.21292/2078-5658-2021-18-2-40-47
Abstract
An important place in the structure of the causes of postoperative respiratory failure in cardiac surgery is occupied by atelectasis of the lung tissue, which is formed during cardiopulmonary bypass (CPB). The incidence of this complication makes 54–92%.
The objective: to evaluate the effectiveness of various respiratory support techniques during CPB.
Subjects and methods. 60 patients were randomly included in the study. CPAP Group (positive airway pressure +5 cm H2O) and VC Group (lung ventilation during CPB with parameters: tidal volume 3 ml/kg, respiratory rate 6/min, positive end-expiratory pressure +5 cm H2O).
Results. The oxygenation index in VC Group was higher than in CPAP Group at the stages after the end of CPB (289.6 ± 100.0 in VC Group and 223.1 ± 152.0 in CPAP Group), at the end of surgery (in VC Group 318,7 ± 73.8 and in CPAP Group 275.2 ± 90.0) The frequency of intraoperative (VC 16% and CPAP 43%) and postoperative recruiting lung maneuvers (VC 7% and CPAP 26%) in VC Group was lower versus CPAP Group. The incidence of atelectasis in VC Group (10%) decreased compared to CPAP (36.6%).
Conclusion: Low-volume ventilation during cardiopulmonary bypass has a more favorable effect on the oxygenating function compared to respiratory support in the CPAP mode.
About the Authors
A. Yu. Kirillov
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Aleksandr Yu. Kirillov, Anesthesiologist and Emergency Physician, Post Graduate
Student of Anesthesiology and Intensive Care Department
8, Bd. 2, Trubetskaya St., Moscow, 119991
A. G. Yavorovskiy
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Andrey G. Yavorovskiy, Doctor of Medical Sciences, Professor of Anesthesiology and Intensive Care Department, Head of Anesthesiology and Intensive Care Department. Anesthesiologist and Emergency Physician
8, Bd. 2, Trubetskaya St., Moscow, 119991
M. A. Vyzhigina
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Margarita A. Vyzhigina, Doctor of Medical Sciences, Professor of Anesthesiology and Intensive Care Department, Anesthesiologist and Emergency Physician
8, Bd. 2, Trubetskaya St., Moscow, 119991
R. N. Komarov
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Roman N. Komarov, Doctor of Medical Sciences, Professor of Faculty Surgery Department no. 1, Cardiovascular Surgeon, Head of Faculty Surgery Department no. 1
8, Bd. 2, Trubetskaya St., Moscow, 119991
P. V. Nogtev
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Pavel V. Nogtev, Candidate of Medical Sciences, Associate Professor of Anesthesiology and Intensive Care Department. Anesthesiologist and Emergency Physician, Head of Anesthesiology and Intensive Care Department no. 1
8, Bd. 2, Trubetskaya St., Moscow, 119991
P. S. Bagdasarov
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Pavel S. Bagdasarov, Anesthesiologist and Emergency Physician, Assistant of Anesthesiology and Intensive Care Department, Head of Anesthesiology and Intensive Care Unit
8, Bd. 2, Trubetskaya St., Moscow, 119991
E. Yu. Khalikova
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Elena Khalikova, Candidate of Medical Sciences, Associate Professor of Anesthesiology and Intensive Care Department, Anesthesiologist and Emergency Physician
8, Bd. 2, Trubetskaya St., Moscow, 119991
D. A. Yavorovskaya
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Darya A. Yavorovskaya, Student
8, Bd. 2, Trubetskaya St., Moscow, 119991
I. I. No
I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Irina I. No, Resident of Anesthesiology and Intensive Care Department
8, Bd. 2, Trubetskaya St., Moscow, 119991
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Review
For citations:
Kirillov A.Yu., Yavorovskiy A.G., Vyzhigina M.A., Komarov R.N., Nogtev P.V., Bagdasarov P.S., Khalikova E.Yu., Yavorovskaya D.A., No I.I. Respiratory tactics during cardiopulmonary bypass in cardiac surgery. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2021;18(2):40-47. (In Russ.) https://doi.org/10.21292/2078-5658-2021-18-2-40-47
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