Efficacy and Safety of Three Alveolar Recruitment Manoeuvres after Off-Pump Coronary Artery Bypass Grafting
Published on: 2016-02-22
The aim of study was to assess the efficacy and safety of three different modes of alveolar recruitment manoeuvre (RM) and to evaluate their influence on early postoperative period after off-pump coronary artery bypass grafting (OPCAB). We randomized 80 adult patients after OPCAB to four groups: ?PAP-40 group was exposed to RM by changing the ventilator mode to continuous positive airway pressure of 40 cm H2O for 40 seconds; in a Peak-40 group, RM was achieved by inflating the lungs at constant flow until a peak inspiratory pressure of 40 cm H2O was reached and held for 40 seconds; the PEEP-15 group received RM by raising the positive end-expiratory pressure to 15 cm H2O for five minutes; the control group received no RM. Arterial oxygenation and dynamic compliance increased in all groups receiving RM (P < 0.017). In the CPAP-40 group, mean arterial pressure decreased significantly during RM (P = 0.01). In the PEEP-15 group, the duration of respiratory support was shortened by 1 hr compared with the control group (P = 0.012). Alveolar RM using Peak-40 and PEEP-15 improved oxygenation after OPCAB without negative influence on haemodynamics. Application of a PEEP of 15 cm H2O for five minutes reduced the time to tracheal extubation.