Therapeutic effect of bilevel positive airway pressure ventilation on severe hypoxemia after off-pump coronary artery bypass grafting

Dang Haiming; Song Bangrong; Dong Ran

doi:10.3760/j.issn.1673-4777.2018.05.012

Abstract：Objective To observe the therapeutic effect of bilevel positive airway pressure ventilation on severe hypoxemia after off-pump coronary artery bypass grafting (OPCABG).Methods From June 2016 to December 2017,41 patients with severe hypoxemia after OPCABG who were refractory to other modes of mechanical ventilation respiratory therapy were enrolled in Beijing Anzhen Hospital,Capital Medical University to have bilevel positive airway pressure ventilation with the PB840 respirator.Oxygenation index,arterial partial pressure of carbon dioxide,respiratory rate,heart rate and mean arterial pressure were recorded before and 4,12 h after bilevel ventilation.Results All patients were successfully weaned from respiratory support after ventilation therapy.Oxygenation index and arterial partial pressure of carbon dioxide 4 h after therapy were significantly higher than those before therapy[(166 ± 22)mmHg vs(149 ± 18)mmHg,(32 ± 5)mmHg vs (28 ± 3)mmHg];respiratory rate and mean arterial blood pressure 4 h after therapy were significantly lower than those before therapy [(28 ± 4)times/min vs (33 ±4)times/min,(90 ±6)mmHg vs (96 ±8)mmHg] (all P＜0.01).Oxygenation index and arterial partial pressure of carbon dioxide 12 h after therapy were significantly higher,respiratory rate and heart rate were significantly lower than those before therapy and those 4 h after therapy;mean arterial blood pressure 12 h after therapy was significantly lower than that before therapy(all P ＜0.01).No adverse events such as circulation instability,pneumothorax and coronary spasm were observed.Conclusion Bilevel positive airway pressure ventilation is effective in treatment of severe hypoxemia after OPCABG.