Al Jaaly et al.[1515 Al Jaaly E, Fiorentino F, Reeves BC, Ind PW, Angelini GD, Kemp S, et al. Effect of adding postoperative noninvasive ventilation to usual care to prevent pulmonary complications in patients undergoing coronary artery bypass grafting: a randomized controlled trial. J Thorac Cardiovasc Surg. 2013;146(4):912-8.], 2013 |
CABG |
126 - 63/63 |
BiLevel+ usual carea, vs. usual carea+ CPAP for six patients who needed ventilation support |
Stratified by BMI: BMI<30: IPAP 12 cmH2O, EPAP 5 cmH2O; BMI≥30: IPAP 17, EPAP 10 cmH2O; for 24h (removed so the patient could eat, or before if they could not tolerate it) |
2x/day on the first two to three days after surgery |
Mortality rate Atelectasis Pneumonia Reintubation rate MV Time Time spent in the ICU Length of hospital stay until release |
Mortality rate: the same in both groups Atelectasis, pneumonia and Reintubation rate: less frequent in the intervention group MV Time: similar between groups (without statistically significant data) Time spent in the ICU: shorter in the intervention group, but without significant difference ( P=0.306) between groups. Length of hospital stay until release: shorter in the intervention group, with significant difference ( P=0.019) between groups, if the medical release is considered; and similar between groups, without significant difference (P=0.552) between groups, if non-medical factors are considered |
Franco et al.[1616 Franco AM, Torres FC, Simon IS, Morales D, Rodrigues AJ. Assessment of noninvasive ventilation with two levels of positive airway pressure in patients after cardiac surgery. Rev Bras Cir Cardiovasc. 2011;26(4):582-90.], 2011 |
CABG |
26 - 13/13 |
BiLevel+ CPbvs. CP |
IPAP: 8 to 12 cmH2O; EPAP: 6 cmH2O, 2x/day for 30 minutes |
2x/day, 2 days after surgery |
Atelectasis Length of hospital stay until release |
Atelectasis: lower in the intervention group, without significant difference (P=0.08) between groups Length of hospital stay: shorter in the intervention group (without statistically significant data) |
Jousela et al.[1111 Jousela I, Räsänen J, Verkkala K, Lamminen A, Mäkeläinen A, Nikki P. Continuous positive airway pressure by mask in patients after coronary surgery. Acta Anaesthesiol Scand. 1994;38(4):311-6.], 1994 |
CABG |
30 - 15/15 |
CPAP vs. oxygen therapy |
CPAP 7.4 cmH2O FiO2 0.3 for 8h |
FiO20.3 for 8h |
AtelectasisPaO2
|
Atelectasis: similar between groups PaO2:better in the intervention group,with significant difference between groups (P<0.05) |
Lopes et al.[88 Lopes CR, Brandão CMA, Nozawa E, Auler Junior JOC. Benefícios da ventilação não-invasiva após extubação no pós-operatório de cirurgia cardíaca. Rev Bras Cir Cardiovasc. 2008;23(3):344-50.], 2008 |
CABG or valve surgery |
100 - 50/50 |
BiLevel vs. oxygen therapy (nasal catheter) |
For 30 minutes, IPAP for generating a VC > 5 ml/kg (average value 10±2.12 cmH2O), EPAP 5 cmH2O, and oxygen attached to the mask at 5 l/min or enough for SpO2> 95% |
5 l/min |
PaO2MV Time |
PaO2: better in the intervention group, with significant difference (P=0.0009) between groups MV Time: similar between groups, without significant difference ( P =0.526) between groups |
Matte et al.[33 Matte P, Jacquet L, Van Dyck M, Goenen M. Effects of conventional physiotherapy, continuous positive airway pressure and non-invasive ventilatory support with bilevel positive airway pressure after coronary artery bypass grafting. Acta Anaesthesiol Scand. 2000;44(1):75-81.], 2000 |
CABG |
96 33,33/30 |
CPAP + CP (coughing, exercises, aerosol therapy, mobilization) or BiLevel + CP vs. CP + IS (volume) |
CPAP 5 cmH2O (1h/3h); BiLevel IPAP 12 cmH2O, EPAP 5 cmH2O (1h/3h) |
CP parameters not described;IS 20/2 h |
AtelectasisPaO2Time spent in the ICU |
Atelectasis: less in the intervention group (without statistically significant data) PaO2:increased in the intervention group, but without significant difference P<0.01Time spent in the ICU: similar, without significant difference between groups |
Mazullo, et al.[2020 Mazzulo Filho JBR, Bonfim VJG, Aquim EE. Ventilação mecânica não invasiva no pós-operatório imediato de cirurgia cardíaca. Rev Bras Ter Intensiva. 2010;22(4):363-8.], 2010 |
CABG, valve replacement,Combined surgeries, Interatrial communication, aneurysm repair |
32 - 14/18 |
NIV (PSV) vs.not described |
PSV PEEP 5 cmH2O; levels of PSV adjusted to reach a current volume of 5 to 8 ml/kg; FiO240%, for 2h |
Not described |
ARF after extubation |
ARF: control group presented higher incidence. (without statistically significant data) |
Oikkonenet al.[1919 Oikkonen M, Karjalainen K, Kähärä V, Kuosa R, Schavikin L. Comparison of incentive spirometry and intermittent positive pressure breathing after coronary artery bypass graft. Chest. 1991;99(1):60-5.], 1991 |
CABG |
52 - 26/26 |
IPPB+CP (chest physiotherapy techniques) vs. IS (volume) + CP |
Airway peak pressure 10 to 15 cmH2O at least four times/day, minimum of 10 satisfactory inspirations, five to 10 minutes each session |
1x/day, more frequently, if necessary CP |
AtelectasisPaO2
|
Atelectasis: less in the intervention group; without significant difference between groups (P>0.1) PaO2:similar values between groups on the first three days |
Pinilla et al.[1717 Pinilla JC, Oleniuk FH, Tan L, Rebeyka I, Tanna N, Wilkinson A, et al. Use of a nasal continuous positive airway pressure mask in the treatment of postoperative atelectasis in aortocoronary bypass surgery. Crit Care Med. 1990;18(8):836-40.], 1990 |
CABG |
58 - 32/26 |
CPAP+ CP (chest physiotherapy) vs. oxygen therapy + CP |
Between 5 and 7.5 cmH2O, for 12h |
Not described |
Atelectasis Hypoxemia (PaO2/FiO2)Time spent in the ICU |
Atelectasis: not different between groups Hypoxemia (PaO2/FiO2): significantly improved ratio in the intervention group, (P<0.05), half an hour until 24h after extubation; after that, a decrease could be noted in both groupsTime spent in the ICU: similar between groups, without significant difference between groups |
Thomas et al.[1818 Thomas AN, Ryan JP, Doran BR, Pollard BJ. Nasal CPAP after coronary artery surgery. Anaesthesia. 1992;47(4):316-9.], 1992 |
CABG |
28 - 14/14 |
CPAP+CP vs. oxygen therapy + CP |
5 cmH2O, for 1h |
Not described |
Hypoxemia |
Hypoxemia: significantly reduced the pulmonary shunt in the intervention group (P=0.016) |
Zarbock et al.[1010 Zarbock A, Mueller E, Netzer S, Gabriel A, Feindt P, Kindgen-Milles D. Prophylactic nasal continuous positive airway pressure following cardiac surgery protects from postoperative pulmonary complications: a prospective, randomized, controlled trial in 500 patients. Chest. 2009;135(5):1252-9.], 2009 |
CABG or heart valve replacement |
468 - 232/236 |
CPAP vs. standard treatmentc
|
10 cmH2O, for at least 6h |
Intermittent CPAP for 10 min every 4h at 10 cm H2O; other information was not described |
Hypoxemia (PaO2/FiO2 <100)Nosocomial PneumoniaReintubation rate MV TimeTime spent in the ICU and at the hospital |
Hypoxemia (PaO2/FiO2<100), pneumonia, reintubation rate: lower in the intervention group, with significant difference between groups (P=0.03) MV Time late extubation group: similar between groups, without significant difference ( P>0.05)Time spent in the ICU and at the hospital:similar between groups; without significant difference(P>0.05) between groups |