Does On-Pump Normothermic Beating-Heart Valve Surgery with Low Tidal Volume Ventilation Protect the Lungs?

Abstract

Inflammation and oxidative stress markers were lower in the group of patients who underwent beating-heart valve surgery with low-volume ventilation. These results reflect less of an ischemic insult and lower inflammation compared with the results for the patients who underwent conventional operations.

Pulmonary complications of cardiopulmonary bypass

“…Apnea not only promotes atelectasis but also promotes the activation of enzymes in the pulmonary circulation that may lead to postoperative lung dysfunction [102] . A small study of patients who underwent valve surgery found that patients managed with beating heart, on CPB, with low tidal volume ventilation throughout had lower levels of inflammatory and oxidative stress markers such as malondialdehyde, lactic acid, and myeloperoxidase [103] . Vital capacity maneuvers one to three times with a pressure of 35–40 cm H 2 O at the end of the CPB period improves oxygenation in the early postoperative period, but there are no sustainable effects on oxygenation or lung function once into the ICU [104] .…”