To support injured lungs, we have been applying bilevel positive airway pressure for adult patients undergoing surgery with cardiopulmonary bypass. Among 120 consecutive patients, 31 patients whose PaO2/FiO 2 decreased to less than 180 after extubation assigned to the intermittent 15min bilevel positive airway pressure (7.3±3.6 times per patient). Bilevel positive airway pressure improved oxygenation (PaO 2/FiO2: 128±43 vs. 198±62, P=0.004) and allowed the patients with poor oxygenation after extubation to maintain PaO 2/FiO2 levels similar to those of the patients without bilevel positive airway pressure. In conclusion, the bilevel positive airway pressure therapy after extubation was effective to improve lung oxygenation non-invasively in adult patients undergoing more invasive surgery with prolonged cardiopulmonary bypass.
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