Critical care medicine
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Critical care medicine · Jan 1985
Postextubation hypoxemia treated with a continuous positive airway pressure mask.
Twenty-seven surgical patients who developed post-extubation hypoxemia unresponsive to routine respiration therapy (incentive spirometry and chest physical therapy) received continuous positive airway pressure (CPAP) delivered through a mask at an inspired oxygen fraction (FIO2) of 0.45. All patients responded with an increased PaO2 and achieved a PaO2/FIO2 ratio of at least 300 with a mean CPAP of 8.3 +/- 2.8 cm H2O. ⋯ Two (7%) patients required reintubation, one for control of excessive secretions and the other for persistent Pseudomonas pneumonia. Mask CPAP was an effective treatment for postextubation hypoxemia in this group of surgical patients.
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Chylous leakage from the thoracic duct into the pleural space may occur after any type of thoracic surgery; however, there are few reports of this condition after coronary artery bypass grafting. A case of chylothorax after combined coronary bypass and mitral valve replacement is reported to illustrate a discussion of its pathologic basis, diagnosis and management.