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European Journal of Cardio-Thoracic Surgery, Vol 11, 248-257, Copyright © 1997 by European Association for Cardio-thoracic Surgery

ARTICLES

Ventilation by external high-frequency oscillations improves cardiac function after coronary artery bypass grafting

B Sideno and J Vaage
Department of Thoracic Surgery, Karolinska Hospital, Stockholm, Sweden.

OBJECTIVE: To compare the effects of ventilation with intermittent positive pressure and external high frequency oscillation by the Hayek Oscillator during the first 5 h after coronary artery bypass grafting. METHODS: Eleven patients were randomized to intermittent positive pressure ventilation throughout the observation period (5 h), while 13 patients were initially ventilated with intermittent positive pressure ventilation, then by external high-frequency oscillations for 4 h, changing to positive pressure ventilation for the last hour. RESULTS: Cardiac index, stroke volume index, right ventricular stroke work index, right ventricular end-diastolic volume index and mixed venous oxygen saturation were significantly increased during ventilation with external high-frequency oscillations, and arteriovenous oxygen content difference was significantly reduced. There were no significant inter- or intragroup differences in fluid accumulation, mean arterial blood pressure, arterial blood gases, pulmonary artery pressure, central venous pressure, pulmonary capillary wedge pressure, heart rate, systemic vascular resistance index, pulmonary vascular resistance index, intrapulmonary shunt fraction, right ventricular ejection fraction, right ventricular end-systolic volume index and left ventricular stroke work index. CONCLUSIONS: Ventilation by external high-frequency oscillations increases cardiac index and improves tissue perfusion. The increased pumping of the heart is probably caused by changes of the intracardiac pressure-volume relationship. The Hayek Oscillator may have distinct cardiovascular benefits as ventilatory assistance in postoperative cardiac surgical patients.

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