After replacement of two heart valves, a patient developed pulmonary complications that were not resolved by bronchodilator, oxygen, and chest physiotherapy. When FI02 0.60 was necessary to maintain Pa02 of 50 to 60 mm Hg and respiratory rate (f) was 40/min, CPAP was started via tracheostomy tube at FIO2 0.60. Respiratory rate fell immediately to 32/min. FIO2 was reduced to 0.40 in 24 hours. After several days, CPAP was discontinued and patient breathed spontaneously on FIO2 0.40 at f 24, the Pao, being 84 mm Hg. Post open-heart surgery is thus added to the list of conditions in which CPAP may be effective.
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