2006 OPEN FORUM Abstracts
THE USE OF PREOPERATIVE FEV1% DURING NONINVASIVE VENTILATION IN RESPIRATORY FAILURE AFTER CABG
Ayse Baysal, M.D., Sabri Dagsali, M.D., Gurkan Komurcu, Cem
Ariyurk,Ufuk Ciloglu, M.D. Anesthesiology and Reanimation, Dr. S. Ersek
Thoracic and Cardiovascular Surgery Hospital, Istanbul, Kadikoy, Turkey.
Introduction: Noninvasive mechanical
ventilation (NIMV) therapy have been used in acute respiratory failure
successully. Postoperatively hypoxemia may have different causes and may not
respond to NIMV. The goal of this study is to compare the efficiency of FEV1% (
forced expiratory volume in first second percent) and arterial blood gas
analysis on the success rate of NIMV. Material
and
Methods: Retrospective analysis of 60 patients that required NIMV
during period of July 2002 and December 2005. The patients were divided into
group 1 (n=30) with normal lung functions (NL), and group 2 (n=30) with chronic
obstructive pulmonary disease (COPD). Demographic data, preoperative FEV1 % ,
arterial blood gases of preoperative, NIMV at 1 hour and 12 hour
postoperatively, were compared in table 1. 36 patients (% 60) had hypercarbic,
whereas 24 (%40) had hypoxemic respiratory failure. The start of the support
was 60 
Results: The FEV1% on group 1 was was
significantly higher than group 2 (100.6
Conclusion: There was no significant
correlation between preoperative %FEV1 and success of NIMV. The decrease in
PaCO2 level should persist to prevent acidosis and for effective response to
therapy.
Table
1. Demographic data, preoperative FEV1%, and arterial blood gases in group NL
and in group COPD preoperative, 1 and 12 hour after NIMV.
| Parameters | Group NL | Group COPD | p |
| Age (years) | 63 |
60 |
NS |
| Height (cm) | 1.67 |
1.61 |
NS |
| Weight (kg) | 74 |
68.4 |
NS |
| %FEV1 | 101 |
61 |
<0.05 |
| pH (A) | 7.23 |
7.24 |
NS |
| paO2 (mmHg)(A) | 59 |
64 |
NS |
| paCO2 (mmHg)(A) | 78 |
81.7 |
NS |
| HCO3 (A) | 79 |
82 |
NS |
| SaO2 (%)(A) | 33 |
33 |
NS |
| pH (B) | 7.35 |
7.36 |
NS |
| paO2 (mmHg)(B) | 98.23 |
102 |
NS |
| paCO2 (mmHg)(B | 56 |
62 |
NS |
| HCO3 (B) | 30 |
31 |
NS |
| SaO2 (%)(B) | 93 |
95.3 |
NS |
| pH (C) | 7.33 |
7.3 |
0.05 |
| paO2 (mmHg)(C) | 110 |
99 |
NS |
| paCO2 (mmHg)(C | 58 |
68 |
0.05 |
| HCO3 (C) | 31 |
34 |
NS |
| SaO2 (%)(C) | 98 |
95 |
NS |
NS:not
significant, p