الفهرس 
Introduction
CARDIOPULMONARY BYPASSOnly 14 pages are availabe for public view
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Abstract
During open heart surgery with cardiopulmonary bypass, thelung is at increased risk of injury which may be caused by lung ischemia, hypothermia, cardiopulmonary bypass itself, medications and massive blood transfusion. Lung injury may be presented by interstitial pulmonary edema and abnormal gas exchange. The use of different ventilatory strategies during CPB was reported by many studies to decrease the risk of lung injury, but it remains controversial whether these procedures provide any significant clinical benefits.We conducted this randomized controlled clinical trial to investigate different ventilatory measures to obtain optimal lung protection during CPB in pediatric noncyanotic open heart surgery.
Methods:60 children were included in this study and allocated into one of three groups according to the type of ventilatory measure during CPB. The conventional group, which received a low flow of 50% air: 50% oxygen.Low rate group, which received a lowrate of 4 cycles/min with thelow tidal volume of 4 ml/kg besidesthe low flow of 50% air: 50% oxygen. CPAP group in which 10 cm H2O was applied during the period of CPB by theclosure of APL valve with alow flow of 50% air: 50% oxygen. Inclusion criteria are elective cardiac surgery with Cardiopulmonary Bypass and acyanotic heart defects. Exclusion criteria includes age less than two years or above 12 years, cyanotic heart defects, preoperative chest problems, known renal or hepatic dysfunctions, planned off-pump cardiac surgery, emergency cardiac surgery, parents refusal
We recorded demographic and surgical data, pre- and postoperative chest CT, lung mechanics, blood gases, hemodynamic parameters and postoperative outcome and complications.
Results:Our study showed that there was no significant difference between the three studied groups as regard lung volumes, static and dynamic compliances, respiratory rate, blood gases and hemodynamic parameters in all times of the study.
Conclusion:
We concluded that the strategies used for lung protection during bypass do not affect the degree of lung atelectasis, post-operative ABG, the incidence of complications after anoperation or post-operative outcomes
Recommendations:
We recommend further studies to be carried out with more homogeneouspatients, and surgeons, other modes of lung protection during bypass may be tried with the evaluation of inflammatory mediator.
Declaration of interest
None declared.
Funding
Equipment used in this study was provided by Assiut University Hospitals, Assiut, Egypt. We received no additional funding.