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Báo cáo y học: "PEEP-ZEEP technique: cardiorespiratory repercussions in mechanically ventilated patients submitted to a coronary artery bypass graft surgery"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: PEEP-ZEEP technique: cardiorespiratory repercussions in mechanically ventilated patients submitted to a coronary artery bypass graft surgery. | Herbst-Rodrigues et al. Journal of Cardiothoracic Surgery 2011 6 108 http www.cardiothoracicsurgery.Org content 6 1 108 JCTS JOURNAL OF CARDIOTHORACIC SURGERY RESEARCH ARTICLE Open Access PEEP-ZEEP technique cardiorespiratory repercussions in mechanically ventilated patients submitted to a coronary artery bypass graft surgery Marcus Vinicius Herbst-Rodrigues1 Vitor Oliveira Carvalho2 José Otávio Costa Auler Jr3 and Maria Ignez Zanetti Feltrim1 Abstract Background The PEEP-ZEEP technique is previously described as a lung inflation through a positive pressure enhancement at the end of expiration PEEP followed by rapid lung deflation with an abrupt reduction in the PEEP to 0 cmH2O ZEEP associated to a manual bilateral thoracic compression. Aim To analyze PEEP-ZEEP technique s repercussions on the cardio-respiratory system in immediate postoperative artery graft bypass patients. Methods 15 patients submitted to a coronary artery bypass graft surgery CABG were enrolled prospectively before 10 minutes and 30 minutes after the technique. Patients were curarized intubated and mechanically ventilated. To perform PEEP-ZEEP technique saline solution was instilled into their orotracheal tube than the patient was reconnected to the ventilator. Afterwards the PEEP was increased to 15 cmH2O throughout 5 ventilatory cycles and than the PEEP was rapidly reduced to 0 cmH2O along with manual bilateral thoracic compression. At the end of the procedure tracheal suction was accomplished. Results The inspiratory peak and plateau pressures increased during the procedure p 0.001 compared with other pressures during the assessment periods however they were within lung safe limits. The expiratory flow before the procedure were 33 7.87 L min increasing significantly during the procedure to 60 6.54 L min p 0.001 diminishing to 35 8.17 L min at 10 minutes and to 36 8.48 L min at 30 minutes. Hemodynamic and oxygenation variables were not altered. Conclusion The PEEP-ZEEP technique seems to be .