اثرات مثبت راه هوایی و تهویه مکانیکی ریه در طی بای پس قلبی ریوی بر عوارض جانبی ریوی

0
Effects of Positive Airway Pressure and Mechanical Ventilation of the Lung During Cardiopulmonary Bypass on Pulmonary Adverse Events After Cardiac Surgery: A Systematic Review and Meta-Analysis

Objective: To investigate whether different ventilation strategies during cardiopulmonary bypass (CPB) can improve outcomes in adult cardiac surgery patients
Design: Systematic review of randomized controlled trials with meta-analyses
Setting: Clinical trials for human studies up to July 2016 were obtained from electronic databases (Medline, Embase, PubMed, and the Cochrane Central Register of Controlled Trials) and reference lists of relevant randomized trials and review articles
Participants: Adult patients under going cardiac surgery
(Interventions: Patients who underwent cardiac surgery with CPB and ventilation or continuous positive airway pressure(CPAP

Measurements and Main Results: Fifteen randomized controlled trials with 748 patients were analyzed. In cardiac surgery, CPAP use during
CPB was associated with an improved alveolar–arterial oxygen gradient difference compared with no CPAP (weighted mean difference
[WMD] ¼ 4.11 kPa; 95% confidence interval [CI] ¼ 0.85-7.37; I2 ¼ 28.8%)

Ventilation during CPB did not improve the postoperative hypoxemia score (WMD ¼ 30.94; 95%CI ¼ 20.76 to82.63;I2 ¼ 61%) or diffusion capacity compared with the apnea group (WMD ¼ 2.59 kPa; 95%CI ¼ 2.49 to7.67;I2 ¼ 81.3%). Neither CPAP nor ventilation during CPB was associated with a shorter mechanical ventilation time or hospitalstay
Conclusions: CPAP during CPB improved the alveolar–arterial oxygen gradient difference compared with apnea, but ventilation during CPB did not. Neither CPAP nor ventilation during CPB demonstrated evidence of improving clinical outcomes in low-or intermediate-risk patients for elective cardiac surgery. The findings are in conclusive because of heterogeneity and small sample sizes

اثرات مثبت راه هوایی و تهویه مکانیکی ریه در طی بای پس قلبی ریوی بر عوارض جانبی ریوی پس از جراحی قلب: یک مرور سیستماتیک و فراتحلیل
واکنش خود را انتخاب کنید!
دیدگاهی بنویسید

ایمیل شما نمایش داده نخواهد شد.