[Ventilatory support after open heart surgery: effects of PEEP and CPAP on gas exchange and lung function (author's transl)]. 1978

P M Suter, and V Demottaz, and M Hemmer

In 11 patients requiring coronary bypass surgery during extracorporeal circulation we measured pulmonary function and hemodynamic variables before surgery and during the postoperative period. None of the patients presented with pulmonary hypertension or cardiac failure. Cardiac surgery with extracorporeal circulation caused an important decrease in functional residual capacity (-60%) and in arterial oxygenation (-44%). In the immediate postoperative period, the addition of a positive end-expiratory pressure (PEEP) to mechanical ventilation produced an increase in functional residual capacity and in arterial oxygen tension, and a slight decrease in cardiac output. In contrast to the results obtained in children after cardiac surgery and in adults presenting with viral pneumonia or respiratory distress after polytrauma or surgery, continuous positive airway pressure during spontaneous breathing (CPAP) did not improve pulmonary gas exchange in our patients, despite the significant increase in functional residual capacity produced. This suggests that CPAP did not cause recruitement of atelectatic areas or that this effect was offset by a parallel overdistension of gas exchange units.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010100 Oxygen An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration. Dioxygen,Oxygen-16,Oxygen 16
D010313 Partial Pressure The pressure that would be exerted by one component of a mixture of gases if it were present alone in a container. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Partial Pressures,Pressure, Partial,Pressures, Partial
D011175 Positive-Pressure Respiration A method of mechanical ventilation in which pressure is maintained to increase the volume of gas remaining in the lungs at the end of expiration, thus reducing the shunting of blood through the lungs and improving gas exchange. Positive End-Expiratory Pressure,Positive-Pressure Ventilation,End-Expiratory Pressure, Positive,End-Expiratory Pressures, Positive,Positive End Expiratory Pressure,Positive End-Expiratory Pressures,Positive Pressure Respiration,Positive Pressure Ventilation,Positive-Pressure Respirations,Positive-Pressure Ventilations,Pressure, Positive End-Expiratory,Pressures, Positive End-Expiratory,Respiration, Positive-Pressure,Respirations, Positive-Pressure,Ventilation, Positive-Pressure,Ventilations, Positive-Pressure
D011184 Postoperative Period The period following a surgical operation. Period, Postoperative,Periods, Postoperative,Postoperative Periods
D011652 Pulmonary Circulation The circulation of the BLOOD through the LUNGS. Pulmonary Blood Flow,Respiratory Circulation,Circulation, Pulmonary,Circulation, Respiratory,Blood Flow, Pulmonary,Flow, Pulmonary Blood,Pulmonary Blood Flows
D012115 Residual Volume The volume of air remaining in the LUNGS at the end of a maximal expiration. Common abbreviation is RV. Residual Volumes,Volume, Residual,Volumes, Residual
D012119 Respiration The act of breathing with the LUNGS, consisting of INHALATION, or the taking into the lungs of the ambient air, and of EXHALATION, or the expelling of the modified air which contains more CARBON DIOXIDE than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration ( Breathing
D005112 Extracorporeal Circulation Diversion of blood flow through a circuit located outside the body but continuous with the bodily circulation. Circulation, Extracorporeal,Circulations, Extracorporeal,Extracorporeal Circulations

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