نتیجه همودینامیک تهویه دست در مقابل تهویه ماشین

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Hemodynamic Consequence of Hand Ventilation Versus Machine Ventilation During Transport After Cardiac Surgery

Objectives: The hemodynamic consequences of ventilation of intubated patients during transport either by hand or using a transport  ventilator have not been reported in patients after cardiac surgery. The authors hypothesized that bag-mask ventilation would alter end-tidalCO2 during transport and hemodynamic parameters in patients post-cardiac surgery

Design: A prospective,randomizedtrial

Setting: A university-affiliated tertiarycarehospital

Participants: Cardiac surgerypatients

Interventions: Thirty-six patients were randomized to hand ventilation or machine ventilation. Hemodynamic variables including blood pressure, heart rate, peripheral saturation of oxygen, and end-tidal carbon dioxide (ETCO2) were measured in these patients prior to transport ,every 2 minutes during transport and upon arrival in the intensive care unit (ICU). Pulmonary artery pressure (PA) pressures were measured at origin and at destination

Measurements and MainResults: Outcomes were changes from baseline in end-tidal CO2, hemodynamic changes from baseline
and pulmonary artery pressure changes from origin to destination
The average transport time between the 2groups was not different
5 minutes for patients ventilated by hand and 5.47 minutes for patients ventilated with a transport ventilator (p ¼ 0.369 by2-sidedt-test)
The difference in all measured changes in ETCO2 between hand-ventilated and machine-ventilated patients during transport was 2.74 mmHg (p ¼ 0.013)
The difference between operating room and ICUETCO2 from each cohort was1.31mmHg (p ¼ 0.067)
The difference in PA mean measured at origin and destination was 0.783 mmHg (p ¼ 0.622)
All other hemodynamic variables were not different during transport

Conclusions: Hand ventilation during transport was associated with greater change from baseline of ETCO2 compared to machine ventilation during transport after cardiac surgery , but this did not translate into any difference in hemodynamic changes upon arrival in ICU
A hemodynamic benefit of machine transport ventilation to cardiac patients was not demonstrated

نتیجه همودینامیک تهویه دست در مقابل تهویه ماشین در حین حمل و نقل پس از جراحی قلب
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