PROPHYLACTIC EFFECT OF DIFFERENT LEVELS OF CONTINUOUS POSITIVE AIR PRESSURE ON THE OCCURRENCE RATE OF PULMONARY COMPLICATIONS AFTER CARDIAC SURGERY

Background: Postoperative pulmonary complications (PPCs) are a signicant cause of morbidity and mortality following cardiac surgery. The prophylactic application of continuous positive airway pressure (CPAP) during the weaning phase from mechanical ventilation may help improve oxygenation and reduce PPCs. Aims and Objective: To evaluate the effect of different levels of pressure support (PS) and positive end-expiratory pressure (PEEP) on pulmonary outcomes in patients after cardiac surgery. Materials and Methods: This prospective, randomized interventional study was conducted in the Department of Anaesthesiology and Intensive Care at Sri Aurobindo Medical College and PG institute, Indore, Madhya Pradesh. A total of 134 patients were randomly assigned into two groups:Group A (n = 67): PS 14 cm H₂O and PEEP 6 cm H₂O and Group B (n = 67): PS 16 cm H₂O and PEEP 8 cm H₂O. Patients were weaned to pressure support ventilation after stabilization. Arterial blood gases (PaO₂, PaCO₂), hemodynamic parameters (HR, MAP), and pulmonary complications were recorded at 0, 4, 6, and 8 hours. Results: Group B showed signicantly better oxygenation (PaO₂) at 4, 6, and 8 hours compared to Group A (p < 0.001 at all-time points). Group B also demonstrated lower rates of pulmonary complications, including atelectasis (10.4% vs. 28.4%, p = 0.01), pneumonia (6% vs. 17.9%, p = 0.04), and reintubation (3% vs. 13.4%, p = 0.03). No signicant differences were observed in PaCO₂ or hemodynamic parameters between the groups, and no barotrauma was reported. Conclusion: Higher levels of pressure support and PEEP (PS 16, PEEP 8) during early weaning signicantly improved oxygenation and reduced the incidence of postoperative pulmonary complications without compromising hemodynamic stability. This strategy may serve as an effective prophylactic approach following cardiac surgery.