Ann Thorac Surg 2002;74:1191-1194
© 2002 The Society of Thoracic Surgeons
a Department of General/Cardiothoracic Surgery, Conemaugh Memorial Medical Center, Johnstown, Pennsylvania, USA
b Department of Pharmacy, Conemaugh Memorial Medical Center, Johnstown, Pennsylvania, USA
Accepted for publication June 7, 2002.
* Address reprint requests to Dr Collier, Department of General/Cardiothoracic Surgery, Conemaugh Memorial Medical Center, 1086 Franklin St, Johnstown, PA 15905-4398 USA
Background. Various strategies have been introduced to minimize transfusion requirements in cardiac surgery. One strategy is the use of positive end-expiratory pressure (PEEP) postoperatively. Currently, PEEP is used in many centers to control increased mediastinal chest-tube drainage. The purpose of this study was to determine whether the prophylactic application of a PEEP of 10 cm H2O compared with a PEEP of 5 cm H2O in the immediate postoperative period reduces mediastinal chest-tube output without causing clinically significant hemodynamic compromise.
Methods. We prospectively studied 84 elective coronary artery bypass grafted patients and randomized treatment groups to a PEEP of 5 or 10 cm H2O. Forty-four patients were assigned a PEEP of 5 cm H2O and 40 patients received a PEEP of 10 cm H2O.
Results. Preoperative, intraoperative, and postoperative demographics were similar between groups. There was no statistically significant difference between the 5 cm H2O PEEP group and the 10 cm H2O PEEP group with regard to chest-tube output at 6 hours, at 24 hours, or in total output. There was no statistical difference in hemoglobin levels immediately postoperatively, at 8 hours, or at 36 hours.
Conclusions. This study demonstrates that the use of postoperative PEEP levels of 10 cm H2O, although safe, does not reduce chest-tube output or transfusion requirements.
This article has been cited by other articles:
The Society of Thoracic Surgeons Blood Conservatio, V. A. Ferraris, S. P. Ferraris, S. P. Saha, E. A. Hessel II, C. K. Haan, B. D. Royston, C. R. Bridges, R. S.D. Higgins, G. Despotis, et al.
Perioperative Blood Transfusion and Blood Conservation in Cardiac Surgery: The Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists Clinical Practice Guideline
Ann. Thorac. Surg., May 1, 2007; 83(5_Supplement): S27 - S86.
[Abstract] [Full Text] [PDF]
|HOME||HELP||FEEDBACK||SUBSCRIPTIONS||ARCHIVE||SEARCH||TABLE OF CONTENTS|
|ANN THORAC SURG||ASIAN CARDIOVASC THORAC ANN||EUR J CARDIOTHORAC SURG|
|J THORAC CARDIOVASC SURG||ICVTS||ALL CTSNet JOURNALS|