ACUTE EFFECTS OF BIPAP-CPAP ON HEMODYNAMICS AND RESPIRATORY PARAMETERS IN MANAGEMENT OF TYPE 2 RESPIRATORY FAILURE PATIENTS

Abstract

Objective: To determine the acute effects of bi-level positive airway pressure vs. continuous positive airway pressure, on hemodynamics and respiratory parameters in management of type-2 respiratory failure in post coronary artery bypass surgery patients.

Study Design: Comparative cross sectional study.

Place and Duration of Study: Adult Cardiac Intensive department, Armed Forces Institute of Cardiology/National Institute of Heart Disease, Rawalpindi, from Dec 2020 to Feb 2021.

Methodology: A total of 60 patients were included in study. Patients were allocated into two groups Bi-level positive airway pressure (n=30) and continuous positive airway pressure, (n=30). Age >18 years of males and females patients with type 2 respiratory failure having PaO2 of <8 kpa and pCO2 of >6kpa guidelines provided by british thoracic society were included.

Results: Results showed no significant differences from baseline to 3rd day for all outcome measures for both groups but patient’s condition get improved clinically. Outcomes measures pCO2, pO2, oxygen saturation with mask, showed (p>0.001), no significant difference was found between groups. pCO2 with (p=0.355), pO2 (p=0.475) and oxygen saturation with mask showed no significant differences between groups.

Conclusion: The outcomes of our study show that both the Bi-level positive airway pressure group and continuous positive airway pressure group have shown improvement in respiratory parameters. We conclude that noninvasive ventilation can be effectively and safely used in type 2 respiratory post coronary artery bypass graft surgery patients to improve oxygenation in mild to moderate level of respiratory insufficiency. It is predominantly useful in patients whose underlying condition warrants avoidance of intubation.