Hernández MM, Guillén DY, Delgado QCA, Hilarión VBA

Language: Spanish
References: 13
Page: 239-244
PDF size: 330.72 Kb.

ABSTRACT

Introduction: among the causes of extubation failure there's a raise of the myocardial systolic work, the American Thoracic Surgeons suggests performing a spontaneous breath test (SBT) with an inspiratory pressure of 5 to 8 cmH₂O instead of a T- piece. Objective: to compare two SBT (T-piece vs PEEP 0/support pressure 0) in the withdrawal of mechanical ventilation in post-operative cardiac surgery patients. Material and methods: retrospective cohort in adults undergoing cardiac surgery with extracorporeal circulation undergoing programmed weaning from mechanical ventilation, a sample size of 60 patients was calculated (powered to 80% and alfa-error of 5%) data obtained from record sheets of each patient. Hemodynamic, gasometric and NT-proBNP variables will be considered. Results: a total of 84 patients, 50 with peep 0/support 0 (60%) and 34 with T-piece (40%) there was no difference in age, weight, height, gender, comorbilities, LVEF, SAPS II time to PVE, proBNP, vital signs, gasometric parameters. Extubation failure: 53.8% in 0/0 and 46.2 in T-piece. p=0.47. In the Burns clinical trial, there was greater success at extubation with the use of pressure support with low evidence in this study extubation failure showed no difference, both techniques were safe. Conclusions: comparing these results with our study, extubation failure at 48 hours in both groups showed no difference. Both techniques showed safety, therefore, extubation success using either of the two spontaneous ventilation tests: CPAP 0/0 vs T-piece in postoperative cardiac surgery patients is similar for both groups.

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