Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional
Official Title: Efficacy and Safety of Using Non-Invasive Ventilation in Postoperative Revascularization of the Myocardium With Alveolar Recruitment Maneuver: Randomized Clinical Trial
Brief Summary: Heart surgery can evolve with complications in the postoperative phase, mainly of a respiratory nature, atelectasis and hypoxemia being the main pulmonary dysfunctions. They can lead to increased length of hospitalization, being the major cause of morbidity and mortality in the postoperative phase of heart surgery. In order to prevent or reduce such complications noninvasive ventilation (NIV) has been used in the postoperative period in a prophylactic and therapeutic manner. The use of positive end expiratory pressure (PEEP) is already widely spread in intensive Care Unit (ICU), being used in patients under mechanical ventilation (MV), NIV and exercises with intermittent positive pressure and has huge scientific publication reporting its benefits for the pulmonary function. The alveolar recruitment maneuver (ARM) consists of sustained increase of pressure in the airway using PEEP in individuals with hypoxemia, in order to minimize the deleterious effects arising from alveolar collapse, providing a more homogeneous ventilation of the pulmonary parenchyma increasing the pulmonary area available for gas exchange and, consequently, arterial oxygenation. In recent years the increase in the application of PEEP in cardiopathic patients under MV has shown great benefits and the use of NIV to improve oxygenation by the reversal of atelectasis is already widely used and recommended in hospital routine. Despite NIV being used in great proportion, the relevant literature is poor in showing studies with NIV and ARM associated in heart surgery. Therefore, the objectives of this study are to evaluate if the use of NIV associated with ARM improves oxygenation in patients in postoperative revascularization of the myocardium related to usual use without ARM, and if it can be applied in a safe manner.