Atelectasis. Pulmonary collapse
Conditions
Interventions
Intervention 1: Patient in the intermediate level of intervention will receive an average 8 cmH2O positive end-expiratory pressure (PEEP) for 4 hours, 30 minutes after entering the intensive care unit
Prevention
Patient in the intermediate level of intervention will receive an average 8 cmH2O positive end-expiratory pressure (PEEP) for 4 hours, 30 minutes after entering the intensive care unit, (provided that
Patient in the high level of intervention will receive an average 10 cmH2O positive end-expiratory pressure (PEEP) for 4 hours, 30 minutes after entering the intensive care unit, (provided that the he
Patients in the control group receive 5 cmH2O positive end-expiratory pressure after surgery, 30 minutes after entering the intensive care unit until the removal of the endotracheal tube.
Sponsors
Vice Chancellor for research Mazandaran University of Medical Sciences.
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Inclusion criteria
Inclusion criteria: The inclusion criteria including: Patients candidate for non emergency open heart surgery (coronary artery bypass and heart valve surgery by sternotomy and cardiopulmonary bypass); Aged from 18 until 65 years; No ejection fraction less than 30% in the angiography form, preoperative; No history of chronic airway obstruction disease and lung trauma; No history of open heart surgery or lung surgery; No history of rib fractures and chest tube insertion; No history of trauma in the head or nose, neurologic disease and frequent sinus infections; No history of chemotherapy and using immunosuppressants three months prior to the surgery; No serum creatinine greater than 3.5 mg/Dl; No body mass index greater than 40 kg/m2; Consciousness level at 15 before surgery; Exclusion criteria including: Arterial systolic pressure less than 90 mmHg despite of fluid intake; Arterial blood pH less than 7.30; Arterial carbon dioxide pressure greater than 50 mmHg; Arterial oxygen saturation less than 80% despite of supplemental oxygen intake; Hemoglobin concentration less than 7 gr/dL; Aortic cross clamp time longer than 150 minutes; Cardiopulmonary bypass time longer than 240 minutes; Using intra aortic balloon pump (IABP) intraoperative and postoperative; Intubation over 24 hours; Also, the patient will be excluded from the study when he/she retransfers to the operating room or when he/she needs ventilator therapy protocols apart from of research protocols.
Exclusion criteria
Exclusion criteria:
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Atelectasis. Timepoint: Two hours after extubation, the third day after surgery (72 hours of operation). Method of measurement: Chest x-rays. | — |
Secondary
| Measure | Time frame |
|---|---|
| Respiratory variable of arterial blood gas (arterial oxygen tension, arterial carbon dioxide tension, arterial oxygen saturation, arterial bicarbonate and arterial blood PH). Timepoint: Before the intervention, one and four hours after the starting of the intervention, before extubation. Method of measurement: ABG test.;Arterial systolic pressure, diastolic blood pressure and mean arterial pressure. Timepoint: Before the intervention, one and four hours after the starting of the intervention, before extubation. Method of measurement: Advanced vital signs monitoring devices.;Heart rate. Timepoint: Before the intervention, one and four hours after the starting of the intervention, before extubation. Method of measurement: Advanced vital signs monitoring devices.;Respiratory rate. Timepoint: Before the intervention, one and four hours after the starting of the intervention, before extubation. Method of measurement: Counting the number of breaths per minute.;Tempreture. Timepoint: Before the intervention, one and four hours after the starting of the intervention, before extubation. Method of measurement: Advanced vital signs monitoring devices thermometer. | — |
Countries
Iran (Islamic Republic of)
Contacts
Public ContactDr Masumeh Bagheri Nesami
Mazandaran University of Medical Sciences
Outcome results
None listed