Effect of Intensive vs Moderate Alveolar Recruitment Strategies Added to Lung Protective Ventilation on PP Complications
Mehwish Naseer, Rafia Tabassum, Aamir Furqan
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ABSTRACT
Aim: to establish the effects of intensive alveolar recruitment therapy in
decreasing the post-operative pulmonary complications. Methodology: A randomized multi centered study was performed with
patients in ICU having hypoxemia after a cardiac surgery. Patients were
allocated to two groups (intensive vs moderate recruitment strategy) with
ventilation having small tidal volume. Severity of post-operative pulmonary
complications was primary outcome. Secondary outcome was duration of stay in
hospital and ICU, hospital mortality and the rate of barotrauma.
Results: The
pulmonary complication severity score of the intensive and moderate group
patients was 1.58±0.91 and 2.10±1.01 respectively. The mean ICU
stay, hospital stay and mechanical ventilation in ICU mean of the intensive
group patients was 4.06±2.12 days, 10.10±3.21 days and 11.26±2.80
respectively. While, the
mean ICU stay, hospital stay and mechanical ventilation in ICU mean of the
moderate group patients was 4.70±2.04 days, 14.09±2.99
days and 12.15±2.08 respectively.
Conclusion: Patients having hypoxemia after a cardiac surgery, intensive alveolar
recruitment therapy proves to be more helpful in decreasing the severity and
occurrence of post-operative pulmonary complications as compared to moderate
alveolar recruitment therapy.
Keywords: Alveolar recruitment, tidal volume, pulmonary complications.