Computed tomography assessment of lung structure in patients undergoing cardiac surgery with cardiopulmonary bypass

Rodrigues, Roseny R.; Sawada, Akifumi; Rouby, Jean‐Jacques; Fukuda, Makiko; Neves, Flávio; Carmona, Maria José Carvalho; Pelosi, Paolo; Auler, José Otávio Costa; Malbouisson, Luíz Marcelo Sá

doi:10.1590/s0100-879x2011007500048

Cited by 20 publications

(24 citation statements)

References 20 publications

(23 reference statements)

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“…Pulmonary complications have an important role following CABG. These problems may vary from a clinically insignificant mild hypoxemia to acute respiratory distress syndrome [1,4]. The main reason for the hypoxemia seen after surgery is ventilation / perfusion mismatch occurrence due to interruption of ventilation [1,[4][5][6][7].…”

Section: Discussionmentioning

confidence: 99%

“…These problems may vary from a clinically insignificant mild hypoxemia to acute respiratory distress syndrome [1,4]. The main reason for the hypoxemia seen after surgery is ventilation / perfusion mismatch occurrence due to interruption of ventilation [1,[4][5][6][7]. The use of CPB may also double the risk of postoperative hypoxemia compared to patients without CPB [1,4,6,7].…”

Section: Discussionmentioning

confidence: 99%

“…The main reason for the hypoxemia seen after surgery is ventilation / perfusion mismatch occurrence due to interruption of ventilation [1,[4][5][6][7]. The use of CPB may also double the risk of postoperative hypoxemia compared to patients without CPB [1,4,6,7]. In a well-designed observational study by Rodrigues and his colleagues on patients with CABG, a 24% increase in collapsed lung tissue, a significant reduction in pulmonary gas volume, an increase in the amount of extravascular pulmonary fluid, and a significant decrease in normally ventilated parenchyma were seen [1].…”

Section: Discussionmentioning

confidence: 99%

“…Complications such as respiratory dysfunction, atelectasis, pneumonia, and pleural effusion are common due to the opening of the thoracic cage and the direct effects of the cardio pulmonary bypass in patients undergoing CABG [1]. Although the mortality and morbidity rates of CABG vary in different series, respiratory failure is an important cause in all the series.…”

Section: Introductionmentioning

confidence: 99%

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The predictive role of computed tomography on respiratory complications following coronary artery bypass surgery

Diken¹

2018

Ann Clin Anal Med

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Aim: Pulmonary complications are frequently seen complications following especially after coronary artery bypass grafting. Attempts are made to detect those complications preoperatively by pulmonary function tests and clinical evaluation.In our study, we investigated the effect of computed tomography findings in predicting postoperative complications in patients with normal respiratory function tests. Material and Method: Between January 2012 and August 2017, imaging records, intensive care and service follow-up records, and policlinic follow-up records of 695 patients who underwent elective isolated CABG at the Department of Cardiovascular Surgery in Hitit University Faculty of Medicine were retrospectively reviewed.Computed tomography images, demographic, and clinical data of the patients who met the inclusion criteria were retrospectively evaluated. Results: Mediastinal lymphadenopathy, emphysema, interlobular septal thickness/ fibrosis, nodule, pleural thickening, tuberculosis sequel, and band/subsegment alatelectasis parameters were evaluated. The most common preoperative radiologic pulmonary pathology was mediastinal lymphadenopathy (n=96, 27.3%), and the least was tuberculosis sequel (n=20, 5.6%). The most common pulmonary complication in thepostoperative period was atelectasis (148 patients, 42%). On logistic regression analysis, emphysema was foundto be a significant predictor of both prolonged mechanical ventilation and bronchospasm (p<0.05). Furthermore, band or subsegmental atelectasis were also predictive for postoperative hypoxemia (p<0.05). Discussion: It can be claimed that pulmonary complications are observed frequently after CABG in patients even with normal respiratory function in the preoperative period; morphologic data of lungs obtained by computerized tomography in these patient groups may be predictive for some of the postoperative complications.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The predictive role of computed tomography on respiratory complications following coronary artery bypass surgery

Diken¹

2018

Ann Clin Anal Med

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“…[31–33] Other studies have been conducted showing that atelectasis is produced to a much larger extent after CPB, resulting in increases of intrapulmonary shunting and postoperative hypoxia. [34,35] Thus, positive airway pressure methods during CPB, such as pulmonary static inflation, improve postoperative gas exchange variables. [36] The possibility that xenon insufflation simply prevented alveolar collapse better than oxygen, is quite likely because solubility, and therefore, absorption is very limited as opposed to oxygen.…”

Section: Discussionmentioning

confidence: 99%