POST-OPERATIVE SPONTANEOUS BREATHING WITH CPAP TO NORMALIZE LATE POST-OPERATIVE OXYGENATION

After intubation for elective upper abdominal surgery 30 patients were randomized in group A or B. Both groups had the same anaesthetics and were ventilated with a tidal volume of 12 ml/kg the rate keeping PaCO2 near 40 mm Hg. Group A was ventilated with ZEEP and group B with PEEP 10 cm H2O. Group A was extubated when VC reached 15 ml/kg and PaCO2 did not exceed 50 mm Hg breathing spontaneously. Group B was allowed to breathe spontaneously with CPAP and PEEP 5 cm H2O (Basel PEEP-WeanerR) for 3 hours before extubation. Measurements: BP, PAP, RAP, HR, Hb, arterial and mixed-venous blood gases with FIO2=0,21. Both groups were similar in age, sex, cigarette consumption, preoperative pulmonary pathology, surgical procedure pathology, surgical procedure and time of operation. Results: RAP, PAP, BP, HR, PaCO2, PaH, Pv-O2 did not show important differences. Mean PaO2 changed as follows:[Figure not available: see fulltext.] Postoperative chest X-rays showed in Group A a total of 56 negative scores, in Group B 25. Conclusion: After upper abdominal surgery the well known decrease of FRC with its increased venous admixture can be prevented if the patient is ventilated with PEEP during operation and is breathing spontaneously with CPAP and PEEP for 3 postoperative hours before extubation. © 1979 Springer-Verlag.