A review of pulmonary problems following valve replacement in 100 consecutive patients: The case against routine use of assisted ventilation

Using strict indications for its use, controlled ventilation was found necessary in only 10 of 100 consecutive patients undergoing valve replacement performed by the authors. The remainder were extubated promptly following operation and did not require controlled ventilation at any time during their postoperative course. While controlled ventilation was more common in patients in certain subclassifications based on preoperative data (N.Y.H.A. Class IV, elevated pulmonary artery pressure, age over 60), 5 of the 10 patients (50%) required respiratory support on the basis of developments occurring during or after operation.Our data indicate that routine use of controlled ventilation following cardiac surgery is unnecessary, as the majority of patients ventilate satisfactorily after operation without the use of respirators. Not using respirators simplifies the postoperative care of these patients and avoids any associated undesirable sequelae.