Interest of the Not Invasive Ventilation Used in Meadow and Post-operative of Cardiac Surgery
Interest of the Not Invasive Ventilation Used in Meadow and Post-operative of Cardiac Surgery
After cardiac surgery, many complications can arise, in particular at the cardiac and lung
 level and it is true especially as the patient is with comorbidity. A patient will be
 considered at risk of a cardiac surgery if risk factors are present in preoperative (obesity,
 Chronic obstructive pulmonary disease (COPD), etc...). The non-invasive ventilation
 (NIV)developed these last years in the treatment of acute cardiac insufficiency and the
 hypercapnic COPD exacerbations; its use is more and more envisaged in cardio-thoracic and
 abdominal surgery services.

 Studies showed that the NIV allowed an improvement of the oxygenation, the lung volumes and a
 decrease of ventilation work. According to these observations, the preventive NIV could
 reduce the incidence of appearance of the lung and/or cardiac complications at the patients
 to risk. we estimate 40 to 50%of cardiac surgery patients at a high risk level and we expect
 to obtain a benefit with this particular population. If we meet our goal (a significant
 difference in terms of morbi-mortality with the preventive NIV versus classical care), we
 expect the systematisation of this procedure to all cardiac surgery high risk patients.
Inclusion Criteria:

 Every patient of more than 18 years, programmed for a cardiac surgery ( valve replacement,
 coronary bypass, aortic surgery) in the service of "Chirurgie Cardio-Thoracique et
 Vasculaire" (CCTV) of the CHRU of Brest

 -  and obesity (BMI > 30 kg/m2

 -  and/or COPD (stages 1-2 and 3, classification GOLD)

 -  and/or restrictive syndrome (CPT 80 %)

 -  and/or cardiac insufficiency (FEVG 55 %)

 -  and/or syndrome of obesity-hypoventilation not requiring an equipment

 -  and/or Syndrome of sleep apnea not requiring an equipment

 Exclusion Criteria:

 -  Patients having a contraindication absolved from the NIV

 -  Patients carrier of a neuro-muscular disease

 -  Patients carrier of a syndrome of sleep apnea and/or COPD, and sailed

 -  Hypercapnic patients (with a limit value of PaCO2 > 55 mm Hg)

 -  Unaffiliated patients to a social diet of safety

 -  Patients under guardianship or under guardianship

 -  Patient who can not follow the NIV program as well as the patients of whom the consent
 was not collected.