Chronic obstructive pulmonary disease in patients undergoing coronary artery bypass grafting

Abstract

The purpose of this study was to evaluate the effect of chronic obstructive pulmonary disease on patients undergoing coronary artery bypass grafting. Between June 1991 and June 1993, 651 patients underwent coronary artery bypass grafting: 37 patients (group I) had significant chronic obstructive pulmonary disease. These patients were compared with 37 matched control subjects (group II). Comparison of the groups was made with regard to postoperative morbidity and mortality. Quality of life of survivors was compared at the last follow-up. More patients in group I had preoperative arrhythmias (8 versus 1, p = 0.014). Group I patients had lower values of forced expiratory volume in 1 second (1.366 +/- 0.032 L versus 2.335 +/- 0.49 L, p < 0.0001), lower oxygen tension (63.5 +/- 8.2 versus 79.1 +/- 13.4 mm Hg, p = 0.001), and higher carbon dioxide tension (44.8 +/- 6.5 mm Hg versus 39.7 +/- 3.6 mm Hg, p = 0.001). After operation patients in group I had a longer hospital stay (8.1 +/- 3.6 days versus 6.6 +/- 1.7 days, p = 0.0236) and longer intensive care unit stay (2.64 +/- 0.9 days versus 1.23 +/- 0.49 days, p = 0.0001). More patients in group I required prolonged intubation (7 versus 1, p = 0.0278) and reintubation (5 versus 1, p = 0.088). More patients in group I had significant arrhythmias (27 versus 9, p < 0.0001). During a 16-month follow-up period, five patients in group I died, whereas none in group II died (p = 0.0271). Four deaths were related to arrhythmias. More group I patients were not functionally improved by the operation (17 versus 3, p = 0.0056). The results of coronary artery bypass grafting in patients with significant chronic obstructive pulmonary disease were not favorable in midterm follow-up. A major cause for morbidity and mortality was postoperative arrhythmias.

Proposição de um escore de risco cirúrgico em pacientes submetidos à cirurgia de revascularização miocárdica

“…Score Sao Lucas Hospital, PUC-RS. Hannan et al 6 Turner et al 7 Nashef et al 9 Magovern et al gives the appearance of deleterious ventricular arrhythmias in the postoperative period [28]. Atrial fibrillation was associated with the occurrence of death in this study.…”

Preoperative, İntraoperative and Postoperative Predictors of Postoperative Respiratory System Complications in Patients Undergoing Open Heart Surgery

“…Postoperatif dö-nemde gelişen solunum yetmezliğinin kadın ve erkek hastalar arasında fark oluşturmadığını gösteren çalışmalar daha fazla olmakla birlikte, kadınlarda solunum sistemi kompilkasyonların erkeklere oranla daha fazla olduğunu belirten çalışmalarda mevcuttur (9,10,11) . Sonuçlarımızda kadın hastalarda uzamış mekanik ventilasyonun daha fazla ortaya çıktı.…”

“…Açık kalp cerrahisi olan hastaların çoğunda hipertansiyon bulunmaktadır (10) . Hipertansiyonun akciğer sıvısında artma ve arteriyel kan O 2 'inde, dinamik kompliyansta, fonksiyonel rezidüel kapasite ile vital kapasitede azalmaya neden olabileceğini düşünen yayınlar mevcuttur (17,19) .…”

Arterial Blood Gas Analysis in Chronic Obstructive Pulmonary Disease Patients Undergoing Coronary Artery Bypass Surgery

“…Unwanted events of the respiratory system, such as respiratory failure and pneumonia, can cause postoperative complication in COPD patients on whom CABG is performed [7]. There are studies showing that as the stages of COPD increase so does morbidity and mortality in COPD patients on whom coronary artery surgery is performed [8,9]. It has been reported in many studies that postoperative complications are most frequently seen in the COPD patient group when compared to the control group [6][7][8][9].…”