Document Detail

The effect of postoperative positive end-expiratory pressure on postoperative bleeding after off-pump coronary artery bypass grafting.
MedLine Citation:
PMID:  25395944     Owner:  NLM     Status:  PubMed-not-MEDLINE    
INTRODUCTION: To compare postoperative prophylactic use of two positive end-expiratory pressure (PEEP) levels in order to prevent postoperative bleeding in patients undergoing off-pump coronary artery bypass grafting (CABG) surgery.
MATERIAL AND METHODS: Sixty patients undergoing an elective off-pump CABG operation were included in this prospective, nonrandomized clinical trial. Patients were divided into two groups as receiving either 5 cm H2O (group 1) or 8 cm H2O PEEP (group 2) after the operation until being extubated. Chest tube outputs, use of blood products and other fluids, postoperative hemoglobin levels, accumulation of pleural and pericardial fluid after the removal of chest tubes, and duration of hospital stay were recorded and compared.
RESULTS: Low- and high-pressure PEEP groups did not differ with regard to postoperative chest tube outputs, amounts of transfusions and crystalloid/colloid infusion requirements, or postoperative hemoglobin levels. However, low-pressure PEEP application was associated with significantly higher pleural (92 ±37 ml vs. 69 ±29 ml, p = 0.03) and pericardial fluid (17 ±5 ml vs. 14 ±6 ml, p = 0.04) accumulation. On the other hand, high-pressure PEEP application was associated with significantly longer duration of hospitalization (6.25 ±1.21 days vs. 5.25 ±0.91 days, p = 0.03).
CONCLUSIONS: Prophylactic administration of postoperative PEEP levels of 8 cm H2O, although safe, does not seem to reduce chest-tube output or transfusion requirements in off-pump CABG when compared to the lower level of PEEP. Further studies with larger sample sizes are warranted to confirm the benefits and identify ideal levels of PEEP administration in this group of patients.
Yahya Yildiz; Ece Salihoglu; Sezai Celik; Murat Ugurlucan; Ilker Murat Caglar; Fatma Nihan Turhan-Caglar; Omer Isik
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Publication Detail:
Type:  Journal Article     Date:  2014-10-23
Journal Detail:
Title:  Archives of medical science : AMS     Volume:  10     ISSN:  1734-1922     ISO Abbreviation:  Arch Med Sci     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-11-14     Completed Date:  2014-11-14     Revised Date:  2014-11-16    
Medline Journal Info:
Nlm Unique ID:  101258257     Medline TA:  Arch Med Sci     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  933-40     Citation Subset:  -    
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