Noninvasive Positive-Pressure Ventilation in Treatment of Hypoxemia After Extubation Following Type-A Aortic Dissection

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• 作者：Yi Yang ; MD^* ; Nan Liu ; MD^* ; ^{1135189276@qq.com} ; Lizhong Sun ; MD^&dagger ; ; Ye Zhou ; MM^* ; Yong Yang ; MM^* ; Wei Shang ; MM^* ; Xiaomi Li ; MM^*
• 关键词：helmet ; noninvasive positive-pressure ventilation ; continuous positive airway pressure ; Stanford type-A aortic dissection ; hypoxemia
• 刊名：Journal of Cardiothoracic and Vascular Anesthesia
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：30
• 期：6
• 页码：1539-1544
• 全文大小：154 K
• 卷排序：30

文摘

To assess the efficacy of noninvasive positive-pressure ventilation (NPPV) in improving hypoxemia after extubation for Stanford type-A aortic dissection and to compare NPPV using a mask or a helmet.DesignProspective, interventional study.SettingDepartment of Cardiac Surgery of the Beijing Anzhen Hospital, a tertiary university hospital.ParticipantsPatients experiencing hypoxemia within 24 hours after extubation for Stanford type-A aortic dissection.InterventionsThe patients were divided into the following 3 groups: high-flux inhalation of oxygen with a Venturi mask (control patients), NPPV with a mask (mask group), and NPPV with a helmet (helmet group) (n = 25/group).Measurements and Main ResultsData for blood gas analysis, vital signs, heart function, and complications were collected before the treatment, after 1 and 6 hours of treatment, and at the end of treatment. The oxygen partial pressure/fraction of inspired oxygenation index or PaO2/FIO2 ratio and the oxygen partial pressure were higher and carbon dioxide partial pressure was lower in the mask and helmet groups compared with that of control patients. Compared with control patients and the mask group, the helmet group showed a slower heart rate, lower average arterial pressure, and improved left ventricular ejection fraction, leading to a lower incidence of reintubation and a shorter hospital stay.ConclusionsNPPV with a helmet may quickly improve oxygen partial pressure, decrease carbon dioxide partial pressure, decrease the reintubation rate, and effectively shorten the hospital stay after extubation for Stanford type-A aortic dissection.