Page 24 - JCTR-10-6

Journal of Clinical and Translational Research 2024; 10(6): 334-342

Journal of Clinical and Translational Research

Journal homepage: http://www.jctres.com/en/home

ORIGINAL ARTICLE

Impact of non-invasive ventilation immediately after extubation on

clinical and functional outcomes in patients submitted to coronary

artery bypass grafting: a clinical trial

André Luiz Lisboa Cordeiro * , Carolina Moura Silva 1 , Kênia de Jesus Lima 1 , Mayana Rocha de Santana 1 ,
1
André Raimundo França Guimarães 2 , Patrícia Forestieri 3 , Luiz Alberto Forgiarini Júnior 4
1 Department of Physiotherapy, Nobre University Center, Feira de Santana, Bahia, Brazil, Noble Institute of Cardiology, Feira de Santana,
2
Bahia, Brazil, Department of Cardiology and Cardiovascular Surgery, Sao Paulo Hospital, Federal University of Sao Paulo, São Paulo, Brazil,
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4 Department of Medicine and Physiotherapy, Catholic University of Pelotas, Porto Alegre, Rio Grande do Sul, Brazil
ARTICLE INFO ABSTRACT

Article history: Background: The use of non-invasive ventilation (NIV) after coronary artery bypass grafting
Received: March 3, 2024 (CABG) may help reduce loss of functional capacity and complications in patients. However, the
Accepted: November 15, 2024 evidence regarding its immediate versus conventional use is controversial.
Published Online: December 5, 2024 Aim: The aim of the study was to assess the impact of immediate NIV after extubation on
oxygenation and the functional capacity of patients undergoing CABG.
Keywords: Methods: This study was a randomized clinical trial involving patients of both sexes, aged 18 years
Myocardial revascularization or older, who have undergone elective CABG with median sternotomy and cardiopulmonary bypass.
Extubation Patients were assessed before and after surgery using the Functional Independence Measure (FIM),
Non-invasive ventilation 6-min walk test (6MWT), and the Medical Research Council (MRC) scale for peripheral muscle
strength. On the 1 day after the surgery, two groups were formed: immediate NIV (NIVI) and
st
*Corresponding author: conventional NIV (NIVC). Hemogasometry was performed before and after NIV, and complication
André Luiz Lisboa Cordeiro rates were assessed. NIVI was administered 1 h after orotracheal extubation, while NIVC was
Department of Physiotherapy, Nobre performed on the first post-operative day, 24 h after extubation. After discharge, the above variables
University Center, 2116 - Centro, Feira de were re-evaluated.
Santana, Bahia, 44001-008, Brazil. Results: A total of 79 patients were evaluated; 46 (58.22%) were men, with a mean age of 65
Email: andre.cordeiro@grupponobre.net ± 9 years. NIVI reduced the reintubation rate in one patient (3%) compared to NIVC with five
patients (12%) (p = 0.01). In the post-intervention period, the inspired oxygen fraction (F O ) was
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© 2024 Author(s). This is an Open- 0.43 ± 0.07 in the NIVC group and 0.30 ± 0.10 in the NIVI group (p = 0.01). The post-intervention
Access article distributed under the terms PaO /F O ratio was 191 ± 45 in the NIVC group and 266 ± 29 in the NIVI group (p < 0.001); the
of the Creative Commons Attribution- ratio one day later was 210 ± 39 in the NIVC group and 279 ± 37 in the NIVI group (p < 0.001).
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Noncommercial License, permitting all
non-commercial use, distribution, and From the 6MWT, the INVI group reported a reduction of 51 ± 36 m compared to a reduction of 95
reproduction in any medium, provided the ± 40 m in the NIVC group (p < 0.01).
original work is properly cited. Conclusion: NIVI after extubation of patients undergoing CABG reduced the loss of functional
capacity, improved blood gas levels, and decreased the rate of reintubation.
Relevance for Patients: This study suggests that the use of NIVI after extubation in patients
undergoing CABG may improve recovery, preserve lung function, and reduce complications such
as reintubation.
1. Introduction

Cardiac surgery (CS) is a widely utilized treatment due to the high incidence of
cardiovascular diseases worldwide [1]. Among the most common procedures, coronary
artery bypass grafting (CABG) stands out as a method that improves blood flow in patients

DOI: http://doi.org/10.36922/jctr.24.00011