Original articleEffects of Alveolar Recruitment on Arterial Oxygenation in Patients After Cardiac Surgery: A Prospective, Randomized, Controlled Clinical Trial
Section snippets
Methods
After institutional review board approval, informed consent was obtained from all participants. Patients undergoing elective primary coronary artery bypass graft surgery with CPB or single-valve repair/replacement surgery were randomly allocated to 1 of 2 groups: group C-VCM (consecutive vital capacity maneuver) and group C (controls). Computer-generated randomization code in blocks of 4 was used for group assignment. Patients undergoing emergency or redo surgery; patients requiring chest
Results
A total of 104 patients were enrolled in the study. Nine patients were excluded (5 from R-VCM and 4 from control groups); 5 patients underwent resternotomy to control postoperative bleeding, 2 patients required prolonged mechanical ventilation because of cardiogenic shock requiring intra-aortic balloon pump, and 2 suffered perioperative stroke. The remaining 95 patients completed the study and were followed until discharge from the hospital. Both groups were similar with respect to their
Discussion
The main finding of this study is that consecutive VCM resulted in better arterial oxygenation extending from the immediate postoperative period to approximately 24 hours after surgery, at the time of ICU discharge.
Impaired arterial oxygenation after cardiac surgery is a well-recognized problem.1, 2, 3 Multiple mechanisms are responsible for acute lung injury after CPB. Oxidant-mediated lung damage as a sequela of ischemia-reperfusion injury; adhesion and sequestration of neutrophils;
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