ROUTINE USE OF POSITIVE END-EXPIRATORY PRESSURE AFTER OPEN-HEART SURGERY

Because atelectasis of the left lobe is a frequent complication of open heart surgery, the efficacy of routine therapy with positive end-expiratory pressure (PEEP) to prevent this complication was evaluated. Patients (24) were randomly assigned to either a group receiving therapy with PEEP (10 patients) or to a group with no PEEP (14 patients). The 2 groups could not be distinguished by age, weight, the forced expiratory volume in 1 s (FEV1), the ratio of FEV1 over the forced vital capacity, the time on the pump, the units of blood transfused, the tidal volume, or the hours of mechanical ventilation. There was no significant roentgenographic difference between the 2 groups in either the degree or frequency ratios tended to improve over time in those patients receiving therapy with PEEP, this improvement was not clinically significant. No complications were encountered with the use of PEEP. The routine use of PEEP following open heart surgery is safe but offers no advantage over standard ventilatory techniques.