Year : 2017  |  Volume : 10  |  Issue : 1  |  Page : 26--30

Elective nasal continuous positive airway pressure to support respiration after prolonged ventilation in infants after congenital cardiac surgery


Hemang Gandhi1, Amit Mishra2, Rajesh Thosani1, Himanshu Acharya3, Ritesh Shah1, Jigar Surti4, Alpesh Sarvaia1 
1 Department of Anesthesia, U. N. Mehta Institute of Cardiology and Research Center (Affiliated to B.J. Medical College), Ahmedabad, Gujarat, India
2 Department of Cardiovascular Thoracic Surgery, U. N. Mehta Institute of Cardiology and Research Center (Affiliated to B.J. Medical College), Ahmedabad, Gujarat, India
3 Department of Research, U. N. Mehta Institute of Cardiology and Research Center (Affiliated to B.J. Medical College), Ahmedabad, Gujarat, India
4 Department of Pediatric Critical Care, U. N. Mehta Institute of Cardiology and Research Center (Affiliated to B.J. Medical College), Ahmedabad, Gujarat, India

Correspondence Address:
Hemang Gandhi
Department of Anesthesia, U. N. Mehta Institute of Cardiology and Research Center, (Affiliated to B.J. Medical College), New Civil Hospital Campus, Asarwa, Ahmedabad - 380 016, Gujarat
India

Background: We sought to compare the effectiveness of oxygen (O2) treatment administered by an O2 mask and nasal continuous positive airway pressure (NCPAP) in infants after congenital cardiac surgery. Methods: In this retrospective observational study, 54 infants undergoing corrective cardiac surgery were enrolled. According to the anesthesiologist's preference, the patients ventilated for more than 48 h were either put on NCPAP or O2 mask immediately after extubation. From pre-extubation to 24 h after treatment, arterial blood gas and hemodynamic data were measured. Results: After 24 h of NCPAP institution, the patients showed a significant improvement in oxygenation compared to O2 mask group. Respiratory rate (per minute) decreased from 31.67 ± 4.55 to 24.31 ± 3.69 (P < 0.0001), PO2 (mmHg) increased from 112.12 ± 22.83 to 185.74 ± 14.81 (P < 0.0001), and PCO2 (mmHg) decreased from 42.88 ± 5.01 to 37.00 ± 7.22 (P < 0.0076) in patients on NCPAP. In this group, mean pediatric cardiac surgical Intensive Care Unit (PCSICU) stay was 4.72 ± 1.60 days, with only 2 (11.11%) patients requiring re-intubation. Conclusion: NCPAP can be used safely and effectively in infants undergoing congenital cardiac surgery to improve oxygenation/ventilation. It also reduces the work of breathing, PCSICU stay, and may reduce the likelihood of re-intubation.


How to cite this article:
Gandhi H, Mishra A, Thosani R, Acharya H, Shah R, Surti J, Sarvaia A. Elective nasal continuous positive airway pressure to support respiration after prolonged ventilation in infants after congenital cardiac surgery.Ann Pediatr Card 2017;10:26-30


How to cite this URL:
Gandhi H, Mishra A, Thosani R, Acharya H, Shah R, Surti J, Sarvaia A. Elective nasal continuous positive airway pressure to support respiration after prolonged ventilation in infants after congenital cardiac surgery. Ann Pediatr Card [serial online] 2017 [cited 2017 Oct 18 ];10:26-30
Available from: http://www.annalspc.com/article.asp?issn=0974-2069;year=2017;volume=10;issue=1;spage=26;epage=30;aulast=Gandhi;type=0