The Application Of Ambroxol And Respiration Training Device During Perioperative Time Improve Pulmonary Function After Extracorporeai Circulation Operation

Objective:The aim of this study is to investigate the effect to pulmonary function after extracorporeal circulatin operation by the application of ambroxol and respiration training device during perioperative time.Method:Patients which had been performed cardiac valve replacement from November2010to August2011in Qilu hospital of Shandong university were selected in this study. Eighty patients were divided into four groups:Group of Ambroxol combinated with respiration training device (Group A), Group of Ambroxol (Group B), Group of respiration training device (Group C) and Control group (Group D). Each group contained20patients. Patients of Group B accepted ambroxol intravenous infusion everyday from3days before operation to5days after operation; Patients of Group C accepted deep breathing exercise everyday from3days before operation to5days after operation; Patients of Group A accepted both these two methods. Patients of Group D were not accepted anyone of them. Arterial blood gas analysis, PO2,PCO2, FiO2and RI were measured at T1(baseline, before extracorporeal circulation), T2(one hour after extracorporeal circulation), T3(12hours after extracorporeal circulation) and T4(24hours after extracorporeal circulation). FiO2, MP and OI were measured respectively at T1, T2and T3. MIV (maximum inspiratory volume) was measured before extracorporeal circulation,24hours after operation,3days and7days after operation. Other observations included cough, viscidity of sputum, difficulty of expectoration and respiratory tract complication. The time of breathing machine assisted ventilation and the time in ICU after extracorporeal circulation operation were recorded. All values were expressed as Mean±Std (x±s). q-test (Newman-Keuls method) was used by SPSS13.0software. A probability value<0.05was regarded as statistically significant.Results:1. RI at T1in all groups were no significant difference (P>0.05); RI in all groups at T2, T3and T4were all increased (P<0.05); RI in Group A at T2, T3and T4were lower than in other groups (P<0.05).2. OI at T1in all groups were no significant difference (P>0.05); OI in all groups at T2and were all increased (P<0.05); OI in Group A and Group B at T2and T3were lower than in other groups (P<0.05), but no significant difference inter the same group (P>0.05).3. MIV in all groups before operation were no significant difference (P>0.05); MIV in all groups after operation decreased compared with those before operation and obviously at3days after operation; Meanwhile MIV in Group A and Group C were higher than in other groups (P<0.05), but no significant difference inter the same group (P>0.05); MIV7days after operation recovered to the preoperative level and no no significant difference between all groups (P>0.05).4. Cough in all groups were no significant difference (P>0.05); Viscidity of sputum in Group A and Group B were lower than in other groups (P<0.05), but no significant difference inter the same group (P>0.05). Difficulty of expectoration in Group A and Group B were lower than in other groups (P<0.01); Difficulty of expectoration in Group A were lower than in Group B (P<0.05).5. The time of breathing machine assisted ventilation and the time in ICU in Group A were shorter than in other groups (P<0.05).6. The application of ambroxol and respiration training device in Group A had the tendency to decrease respiratory tract complication. Conclusions:The application of ambroxol and respiration training device during perioperative time could contributed to protect the pulmonary function, decrease the pulmonary injury caused by CPB and the respiratory tract complication, decrease the time of breathing machine assisted ventilation and the time in ICU.