INTRODUCTION
Cardiac surgery (CS) is a widely used treatment process due to the high
incidence of cardiovascular disease worldwide1. Among
the most common surgeries, coronary artery bypass grafting (CABG) stands
out, a procedure that improves the quality of life of patients with
symptomatic myocardial ischemia, when one or more coronary arteries are
obstructed by atheroma plaques leading to a decrease in blood flow to
the heart muscle2. Patients undergoing CABG show
significant results, but the vast majority develop postoperative
pulmonary disorders3.
After surgery, there is a decrease in ventilatory muscle strength and
pulmonary function, causing a negative impact on these
patients4. Thus, the appearance of pulmonary
complications can cause unfavorable clinical outcomes such as
atelectasis, pneumonia, pulmonary edema and acute respiratory failure
(ARF), favoring negative functional results5,6. Some
factors such as age, overweight, sex, type of surgery and intraoperative
conditions can contribute to the development of these
complications7.
Noninvasive ventilation (NIV) can be used right after extubation in
order to minimize pulmonary dysfunction, reduce the length of stay in
the intensive care unit (ICU) and represent an improvement in the
functional capacity of these patients8,9,10,11.
According to the mechanical ventilation (MV) guideline, NIV should be
performed immediately after extubation, however in some services it
appears on the first postoperative day as the institution’s
protocol12. There is still little evidence for
validation in relation to clinical and functional outcomes if NIV
immediately after extubation may be more appropriate when compared to
that performed in the first postoperative day.
Despite being a recommendation of Brazilian guidelines, the application
of NIV immediately after extubation is not yet a reality in most ICUs.
Therefore, this work can confirm the importance of this therapy in
patients undergoing CABG12. The purpose of this study
was to compare the clinical and functional impact of two post-extubation
(or prophylactic) non-invasive mechanical ventilation protocols for
patients undergoing coronary artery bypass graft surgery.