Influence of Non Invasive Mechanical Ventilation on Tissue Perfusion in Patients After Cardiac Surgery
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Heart Diseases
- Sponsor
- Federal University of São Paulo
- Enrollment
- 80
- Primary Endpoint
- Evaluation of central venous oxygen saturation to determine tissue perfusion
- Status
- Completed
- Last Updated
- 9 years ago
Overview
Brief Summary
This study evaluates whether noninvasive ventilation with continuous positive airway pressure affects tissue perfusion in patients after cardiac surgery.
Detailed Description
Patients submitted to open chest cardiac surgery will be enrolled after ICU admission. These patients will be submitted to noninvasive mechanical ventilation with continuous positive airway pressure right after extubation and tissue perfusion markers (central venous oxygen saturation (SVcO2) and lactate) will be obtained via central venous catheter. Noninvasive mechanical ventilation is a common resource in the ICU to reduce extubation failures and to improve clinical outcomes, whether it can influence tissue perfusion remains unclear. This study evaluates whether noninvasive ventilation affects tissue perfusion and whether tissue perfusion markers in the ICU are correlated with better clinical results for patients after heart surgery.
Investigators
Natasha de Oliveira Marcondi
Principal Investigator
Federal University of São Paulo
Eligibility Criteria
Inclusion Criteria
- •Presence of central venous catheter
- •Invasive arterial pressure catheter
- •Invasive mechanical ventilation
Exclusion Criteria
- •Chronic obstructive pulmonary disease
- •Morbid obesity
- •Hemodynamic instability
- •Spontaneous breathing
- •Need of invasive mechanical ventilation for more than 24 hours
- •Intolerance to noninvasive mechanical ventilation
- •Extubation failure
Outcomes
Primary Outcomes
Evaluation of central venous oxygen saturation to determine tissue perfusion
Time Frame: Through study completion, an average of 1 year
All patients will be admitted in ICU after surgery and will be submitted to four blood collections from the central venous catheter at different times to evaluate central venous oxygen saturation. Time 1: at ICU admission in mechanical ventilation. Time 2 : twenty minutes after extubation, before the noninvasive ventilation protocol, while breathing spontaneously with a 40% oxygen mask. Time 3: At 60 minutes of noninvasive ventilation protocol. Time 4: twenty minutes after noninvasive ventilation protocol complete while breathing spontaneously with a 40% oxygen mask. The results will be compared between then to assess if there are changes under influence of non invasive ventilation.
Evaluation of arterial lactate to determine tissue perfusion
Time Frame: Through study completion, an average of 1 year
All patients will be admitted in ICU after surgery and will be submitted to four blood collections from the arterial invasive catheter at different times to evaluate arterial lactate. Time 1: at ICU admission in mechanical ventilation. Time 2 : twenty minutes after extubation, before the noninvasive ventilation protocol, while breathing spontaneously with a 40% oxygen mask. Time 3: At 60 minutes of noninvasive ventilation protocol. Time 4: twenty minutes after noninvasive ventilation protocol complete while breathing spontaneously with a 40% oxygen mask. The results will be compared between then to assess if there are changes under influence of non invasive ventilation.
Secondary Outcomes
- Respiratory complications during hospitalization(Through study completion, an average of 1 year)
- Hemodinamycs complications during hospitalization(Through study completion, an average of 1 year)