Effectiveness of Assisted Ventilation Supplemented by RTX and NPPV for the Prevention of Postoperative Respiratory Failure in a Patient with Severe COPD Undergoing Total Arch Replacement
10.4326/jjcvs.37.112
- VernacularTitle:最重症 COPD 合併症例に対する弓部全置換術後に陽・陰圧体外式人工呼吸器 （RTX） と非侵襲的陽圧換気 （NPPV） が有効であった1例
- Author:
Hitoshi Terada
;
Katsushi Yamashita
;
Naoki Washiyama
;
Kazuhiro Ohkura
;
Satoshi Akuzawa
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2008;37(2):112-115
- CountryJapan
- Language:Japanese
-
Abstract:
A 74-year-old man with very severe chronic obstructive pulmonary disease (COPD) was scheduled for elective total arch replacement for a distal arch saccular aneurysm. Postoperative respiratory failure was anticipated because of a marked reduction in forced expiratory volume in one second (FEV1.0 - less than 0.5l). Through median sternotomy, total arch replacement using selective cerebral perfusion was completed uneventfully. Postoperative respiratory condition was stable. Therefore, the patient was extubated on postoperative day 2 (POD2). However, as the respiratory condition started getting worse, respiratory therapy external (RTX) was introduced to assist ventilation. Additionally, non-invasive positive pressure ventilation (NPPV) with BiPAP was used on POD3 and management with both RTX and NPPV was continued during the remainder of the intensive care unit stay. As a result, we were able to avoid re-intubation. In conclusion, assisted ventilation supplemented by RTX and NPPV was useful for the prevention of postoperative respiratory failure in a patient with very severe COPD undergoing total arch replacement.
