Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 27 , ISSUE 12 ( December, 2023 ) > List of Articles

Original Article

Analysis of Different Tidal Volumes on Ventilatory Mechanics and Arterial Blood Gas Variables in Patients Undergoing Cardiac Surgery

André Luiz Cordeiro, Adriele Souza, Carolina Ribeiro de Brito Lima, Jaclene Araújo, Hayssa Mascarenhas, André Guimarães

Keywords : Arterial blood gas analysis, Cardiac surgery, Mechanical ventilation

Citation Information : Cordeiro AL, Souza A, Lima CR, Araújo J, Mascarenhas H, Guimarães A. Analysis of Different Tidal Volumes on Ventilatory Mechanics and Arterial Blood Gas Variables in Patients Undergoing Cardiac Surgery. Indian J Crit Care Med 2023; 27 (12):930-933.

DOI: 10.5005/jp-journals-10071-24582

License: CC BY-NC 4.0

Published Online: 30-11-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Introduction: Cardiovascular diseases have been increasing gradually each year, and their incidence has reached 80%. Mechanical ventilation (MV) is essential in the postoperative period of cardiac surgery (CS) due to anesthetic induction. The tidal volume (TV) is a parameter that depends on the conditions of the respiratory system mechanics, aiming at the reduction of dynamic hyperinflation. Objective: Analyze the effect of different TVs on blood gas analysis variables and respiratory mechanics in patients submitted to CS. Materials and methods: This was an uncontrolled randomized clinical trial. Patients were randomized by lottery into the following two groups: One group was ventilated with a TV of 6 mL/kg; while the other received a TV of 8 mL/kg. After 30 minutes of admission with the VT, blood gas analysis data were evaluated, such as pH, oxygen arterial pressure (PaO2), arterial pressure of carbon dioxide (PaCO2), and peripheral oxygen saturation (SpO2). The evaluation of respiratory mechanics was composed of static and dynamic compliance, airway resistance, and driving pressure. Results: A total of 78 patients were included, 58% of whom were males with a mean age of 55 ± 13 years. It was observed that there were no significant differences regarding respiratory mechanics, only the driving pressure presented statistical significance, the group 6 mL/kg was 8.3 ± 2.5 in the group 8 mL/kg 10.4 ± 2.1 presenting a value of (p < 0.001). Conclusion: Based on the findings of the present study, we conclude that different TVs do not significantly alter the blood gas variables and do not influence the respiratory mechanics of patients undergoing CS.

  1. Pereira KSM, Oliveira JGP, Carvalho FC, Bellen BV. Cardiac complications in vascular surgery. J Vasc Bras 2016;15(1):16–20. DOI: 10.1590/1677-5449.003515.
  2. Dessotte CAM, Rodrigues HF, Furuya RK, Rossi LA, Dantas RAS. Stressors perceived by patients in the immediate postoperative of cardiac surgery. Rev Bras Enferm 2016;69(4):694–703. DOI: 10.1590/0034-7167.2016690418i.
  3. Reis FF, de Moura Reboredo M, Lucinda LMF, Bianchi AMA, Rabelo MAE, da Fonseca LMC, et al. Pre-treatment with dexamethasone attenuates experimental ventilator-induced lung injury. J Bras Pneumol 2016;42(3):166–173. DOI: 10.1590/S1806-37562015000000350.
  4. Assmann CB, Vieira PJC, Kutchak F, Rieder MM, Forgiarini SGI, Forgiarini LA. Lung hyperinflation by mechanical ventilation versus isolated tracheal aspiration in the bronchial hygiene of patients undergoing mechanical ventilation. Rev Bras Ter Intensiva 2016;28(1):27–32. DOI: 10.5935/0103-507X.20160010.
  5. Barbas CS, Isola AM, Farias AM, Cavalcanti AB, Gama AM, Duarte AC, et al. Brazilian recommendations of mechanical ventilation 2013. Part I. Rev Bras Ter Intensiva 2014;26(2):89–121. DOI: 10.5935/0103-507x.20140017.
  6. Bispo IMJ, Santos PHS, Carneiro MAO, Santana TDB, Fernandes MH, Casotti CA, et al. Cardiovascular risk factors and sociodemographic characteristics in elderly people registered in a Family Health Unit. O Mundo da Saúde 2016;40(3):334–342. DOI: 10.15343/0104-7809.20164003334342.
  7. Briva A, Gaiero C. Lung protection: An intervention for tidal volume reduction in a teaching intensive care unit. Rev Bras Ter Intensiva 2016;28(4):373–379. DOI: 10.5935/0103-507X.20160067.
  8. Fonseca NM, Martins AV, Fonseca GG. Protective mechanical ventilation, use for everyone? Revista Medica de Minas Gerais 2014;24(8):67–72. DOI:
  9. Schultz MJ, Neto AS. Optimizing perioperative mechanical ventilation as a key quality improvement target. Rev Bras Ter Intensiva 2015;27(2):102–104. DOI: 10.5935/0103-507X.20150019.
  10. Pires KMP, Melo AC, Lanzetti M, Casquilho NV, Zin WA, Porto LC, et al. Mechanical ventilation with low tidal volume and oxidative stress in healthy mouse lungs. J Bras Pneumol 2012;38(1):98–104. DOI: 10.1590/s1806-37132012000100014.
  11. Amato MB, Barbas CS, Medeiros DM, Magaldi RB, Schettino GP, Lorenzi-Filho G, et al. Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med 1998;338(6):347–354. DOI: 10.1056/NEJM199802053380602.
  12. Futier E, Constantin JM, Paugam-Burtz C, Pascal J, Eurin M, Neuschwander A, et al. A trial of intraoperative low-tidal-volume ventilation in abdominal surgery. N Engl J Med 2013;369(5):428–437. DOI: 10.1056/NEJMoa1301082.
  13. Zamani MM, Najafi A, Sehat S, Janforooz Z, Derakhshan P, Rokhtabnak F. The effect of intraoperative lung protective ventilation vs conventional ventilation, on postoperative pulmonary complications after cardiopulmonary bypass. J Cardiovasc Thorac Res 2017;9(4): 221–228. DOI: 10.15171/jcvtr.2017.38.
  14. Nozawa E, Kobayashi E, Matsumoto ME, Feltrim MIZ, Carmona MJC, Júnior JOCA. Assessment of factors that influence the weaning of patients on prolonged mechanical ventilation after cardiac surgery. Arq Bras Cardiol 2003;80(3):301–305. DOI:
  15. Pelosi P, Rocco PR. Airway closure: The silent killer of peripheral airways. Crit Care 2007;11(1):114. DOI: 10.1186/cc5692.
  16. Chan ED, Welsh CH. Geriatric respiratory medicine. Chest 1998;114(6):1704–1733. DOI: 10.1378/chest.114.6.1704.
  17. Júnior NAL, Bacelar SC, Japiassú AM, Cader SA, Lima RCF, Dantas EHM, et al. Arterial blood gas analysis in two different intra-hospital transport methods for postoperative cardiac surgery patients. Rev Bras Ter Intensiva 2012;24(2):162–166. PMID: 23917764.
  18. Castellana FB, Malbouisson LM, Sá Carmona MJC, Lopes CR, Júnior JOCA. Comparison between pressure controlled and controlled mandatory ventilation in the treatment of postoperative hypoxemia after myocardial revascularization. Rev Bras Anestesiol 2003;53(4):440–448. DOI: 10.1590/s0034-70942003000400003.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.