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The Influence of IPPB,CPAP, and IPPB with CPAP during Cardiopulmonary Bypass on Postbypass and Postoperative Pulmonary Function
Authors:Theodore H. Stanley  Wen-Shin Liu  Jesus Isern-Amaral  Scott Gentry  Judd K. Lunn
Affiliation:From the Department of Anesthesiology and the Division of Artificial Organs, Department of Surgery, University of Utah College of Medicine, Salt Lake City, UT.
Abstract:Pulmonary compliance and shunt (
/></figure><sub>S</sub>/<figure class=/></figure><sub>T</sub>) were employed to determine the optimal method for maintaining the lungs during cardiopulmonary bypass in 100 calves. The calves were divided into four groups with respect to pulmonary maintenance during bypass: nonventilation with the lungs collapsed (Group 1); nonventilation with the lungs exposed to 5 cm H<sub>2</sub>O of continuous positive airway pressure (CPAP) (Group 2); intermittent positive-pressure breathing (IPPB) without CPAP (Group 3); and IPPB with 5 cm H<sub>2</sub>O of CPAP (Group 4). All groups had similar compliance preoperatively and sustained significant decreases 30 minutes after bypass. Lung compliance returned to preoperative levels two hours postoperatively in Groups 1 and 2 but was still reduced in Groups 3 and 4. The <figure class=/></figure><sub>S</sub>/<figure class=/></figure><sub>T</sub> was markedly higher postoperatively in Groups 3 and 4 than in Groups 1 and 2.These data demonstrate that ventilation during bypass reduces early postoperative lung compliance and increases <figure class=/></figure><sub>S</sub>/<figure class=/></figure><sub>T</sub> and they suggest that static pulmonary inflation during bypass offers no advantages over allowing the lungs to remain collapsed.</td> </tr> <tr> <td align=
Keywords:Address reprint requests to Dr. Stanley   Department of Anesthesiology   University of Utah College of Medicine   Salt Lake City   UT 84132.
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