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Continuous positive-airway pressure after open-heart operations in infancy.

Abstract In an attempt to assess the effects of continuous positive-airway pressure (C.P.A.P.) on oxygenation, arterial blood-gas measurements were made on 13 infants between 2 and 24 hours after open-heart operations. Samples were taken during intermittent positive-pressure ventilation, and also whilst breathing spontaneously before, during, and after the application of C.P.A.P. Inspired oxygen concentration was kept constant for each infant. Total static compliance of the respiratory system was measured in 10 cases. The use of C.P.A.P. produced a significant increase in arterial oxygen tension in infants with preoperative pulmonary venous obstruction, and in these infants postoperative compliance was low. C.P.A.P. produced no significant change in infants with transposition of the great arteries or ventricular septal defect where postoperative compliance was normal. It is suggested that the use of C.P.A.P. should be restricted to those conditions in which pulmonary compliance is low.