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William S. Hoffman
Donald N. Tomasello
Horace MacVaugh
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Ann Thorac Surg 1982;34:71-73
© 1982 The Society of Thoracic Surgeons

Articles

Control of Postcardiotomy Bleeding with PEEP

William S. Hoffman, M.D.*, Donald N. Tomasello, M.D., Horace MacVaugh, M.D.

From the Lankenau Hospital, Philadelphia, PA

Accepted for publication July 16, 1981.

* Address reprint requests to Dr. Hoffman, Suite 222, Lankenau Medical Building, Lancaster Ave, Philadelphia, PA 19151

One hundred consecutive patients undergoing open-heart operation were selected for investigation of the prophylactic and therapeutic use of positive end-expiratory pressure (PEEP) to control postoperative bleeding. Five cm of PEEP was applied after placement of sternal wires. Patients who bled more than 200 ml per hour were treated with increasing increments of PEEP until hemorrhage terminated or reoperation was required.

After 8 hours, the total blood loss per patient was 281 ml for the PEEP group versus 340 ml for the controls (p > 0.05). Other variables showed no significant differences.

Fifteen patients bled an average of 406 ml (range, 242 to 991 ml) in the first hour in the intensive care unit; they formed the PEEP treatment group. In all patients bleeding decreased to less than 60 ml per hour within 3 hours. No complications of PEEP occurred, and no patient required reoperation to control hemorrhage.




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