I-level positive airway pressure ventilation for patients with hypoxemia after coronary artery bypass grafting

Abstract

Coronary artery bypass grafting (CABG) is an effective scheme for treatment of myocardial ischemia.Hypoxemia is a common complication of CABG, which can affect surgical effect and prognosis and eveninduce multiple organ failure. To explore the clinical efficacy of bi-level positive airway pressure ventilationin the treatment of CABG-associated hypoxemia, 216 patients who were admitted to our hospital betweenAugust 2015 and April 2017 and developed CABG-associated hypoxemia were selected and randomlydivided into 2 groups, an observation group (n=108) and a control group (n=108). Patients in the controlgroup were given conventional treatment including continuous oxygen inhalation through nasal tube, antiinfection,bronchodilation, phlegm resolving, nutrition support, analgesia, cardiac function maintenance,coronary dilatation, anticoagulation and maintenance of stable internal environment, while patients inthe observation group were given positive airway pressure ventilation via a breathing machine or nasalmask besides the conventional treatment. The arterial blood gas indexes and blood circulation indexes ofpatients in the two groups were detected before and after treatment, the number of cases of reintubationwas recorded, and the curative effects were analyzed. The results demonstrated that the arterial gasindexes and blood circulation indexes of patients in the observation group improved after treatment, andthe improvement of the observation group was significantly superior to that of the control group (P<0.05).The intensity of hypoxia of the observation group was higher, and the number of cases of reintubation ofthe observation group was lower than that of the control group (P<0.05). Thus bi-level positive airwaypressure ventilation is an effective non-invasive ventilation mode for treating CABG-associated hypoxemiabecause it can improve p(O2), reduce p(CO2) in a short time, relieve blood circulation, and reduce therate of reintubation. Patients who develop hypoxemia after removal of tracheal intubation are advised toundergo bi-level positive airway pressure in the early stage.