Hipoxemia após revascularização miocárdica: análise dos fatores de risco

Szeles, Tais Felix; Yoshinaga, Eduardo Muracca; Alencar, Wellington; Brudniewski, Marcio; Ferreira, Flávio Silva; Auler, José Otávio Costa; Carmona, Maria José Carvalho; Malbouisson, Luíz Marcelo Sá

doi:10.1590/s0034-70942008000200005

Cited by 34 publications

(34 citation statements)

References 17 publications

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“…In our result, the most frequent postoperative pulmonary complications were pleural effusion and atelectasis, confirming another study that showed pleural effusion frequency of 84% and atelectasis of 65% (8). The frequency of pulmonary complications is high after CAGB, reaching 40%, contributing to patient morbidity and mortality, increased hospitalization times and a rise in hospital costs (23,24).…”

Section: Resultssupporting

confidence: 87%

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Pulmonary complications in patients undergoing coronary artery bypass grafting at a hospital in Maceio, Brazil

et al. 2016

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Pulmonary complications in patients undergoing coronary artery bypass grafting at a hospital in Maceio, Brazil [I] Complicações pulmonares em pacientes submetidos à cirurgia de revascularização do miocárdio em um hospital de Maceió [A] Ana Carolina do Nascimento Calles [a] , Jéssyca Lane Fausto Lira [a] , Karolyne Soares Barbosa Granja [a] , Jaime Dativo de Medeiro [a] , Adoniran Rodrigues Farias [b] , Ricardo César Cavalcanti [c]* [a] Centro Universitário Tiradentes (UNIT), Maceió, AL, Brazil [b] Universidade Estadual de Ciências da Saúde de Alagoas (UNCISAL), Maceió, AL, Brazil [c] Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil [R] Abstract Introduction: Despite technological advances aimed at reducing complications and hospital stay, pulmonary complications in the postoperative period of CABG surgery remain one of the most important causes of morbidity. These may be related to the patient's quality of life, the use of cardiopulmonary bypass, as well as a decline in postoperative respiratory muscle strength, contributing to the emergence of restrictive respiratory disorders. Objective: Assess pulmonary complications in patients undergoing coronary artery bypass graft surgery and identify their association with risk factors. Methods: A retrospective study with non-probability convenience sampling of 168 patients at the Hospital Calles ACN, Lira JLF, Granja KSB, Medeiro JD, Farias AR, Cavalcanti RC. 662 failure (1.2%); and bronchopneumonia (0.6%). Female patients and those aged 70 years or older experienced more pulmonary complications after surgery. Conclusion: Women and patients older than 70 years had the most severe postoperative pulmonary complications, the most common being pleural effusion and atelectasis.

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Section: Resultssupporting

confidence: 87%

“…The use of CEC and the absence of pulmonary ventilation during this period are also determining factors in the development of pulmonary complications after cardiac surgery, likely due to alterations in the mechanical properties of the respiratory system caused by changes in complacency and pulmonary resistance (7,8,9).…”

Section: Introductionmentioning

confidence: 99%

Pulmonary complications in patients undergoing coronary artery bypass grafting at a hospital in Maceio, Brazil

et al. 2016

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“…CPB is considered the main responsible for lung damage, whereas all patients undergoing CPB suffer some disorder of respiratory function due to various factors such as interstitial edema, pulmonary congestion, damage to the pulmonary vascular endothelium and microatelectasis [8,9,11,16,17].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of pulmonary complications of patients on the preoperative period can be noted on the 1 st postoperative day and on the 6th postoperative day. A greater number of radiographs changed on the 6 th postoperative day was found (78%) compared to the 1st postoperative day (40%), occurring on intubation, decrease of respiratory complications and thus resulting in reduced length of hospital stay associated with the reduction in hospital costs [5,8,10,20,21].…”

Section: Radiological Findingsmentioning

confidence: 99%

“…The use of CPB and absence of pulmonary ventilation during this period are also determining factors in the development of pulmonary complications after heart surgery, probably by changes in mechanical properties of the respiratory system resulting from changes in pulmonary compliance and resistance [8,9]. Moreover, the anesthetic procedure, the use of internal mammary artery and stay on mechanical ventilation contribute to pulmonary complications [5,8,10].…”

Section: Introductionmentioning

confidence: 99%

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Perfil ventilatório dos pacientes submetidos a cirurgia de revascularização do miocárdio

Morsch¹,

Leguisamo²,

Camargo³

et al. 2009

Rev Bras Cir Cardiovasc

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Effect of nitric oxide delivery via cardiopulmonary bypass circuit on postoperative oxygenation in adults undergoing cardiac surgery (NOCARD trial): a randomised controlled trial

Azem,

Novakovsky,

Krasulya

et al. 2024

European Journal of Anaesthesiology

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BACKGROUND Cardiac surgery involving cardiopulmonary bypass induces a significant systemic inflammatory response, contributing to various postoperative complications, including pulmonary dysfunction, myocardial and kidney injuries. OBJECTIVE To investigate the effect of Nitric Oxide delivery via the cardiopulmonary bypass circuit on various postoperative outcomes. DESIGN A prospective, single-centre, double-blinded, randomised controlled trial. SETTING Rabin Medical Centre, Beilinson Hospital, Israel. PATIENTS Adult patients scheduled for elective cardiac surgery were randomly allocated to one of the study groups. INTERVENTIONS For the treatment group, 40 ppm of nitric oxide was delivered via the cardiopulmonary bypass circuit. For the control group, nitric oxide was not delivered. OUTCOME MEASURES The primary outcome was the incidence of hypoxaemia, defined as a paO 2/FiO2 ratio less than 300 within 24 h postoperatively. The secondary outcomes were the incidences of low cardiac output syndrome and acute kidney injury within 72 h postoperatively. RESULTS Ninety-eight patients were included in the final analysis, with 47 patients allocated to the control group and 51 to the Nitric Oxide group. The Nitric Oxide group exhibited significantly lower hypoxaemia rates at admission to the cardiothoracic intensive care unit (47.1 vs. 68.1%), P = 0.043. This effect, however, varied in patients with or without baseline hypoxaemia. Patients with baseline hypoxaemia who received nitric oxide exhibited significantly lower hypoxaemia rates (61.1 vs. 93.8%), P = 0.042, and higher paO 2/FiO2 ratios at all time points, F (1,30) = 6.08, P = 0.019. Conversely, this benefit was not observed in patients without baseline hypoxaemia. No significant differences were observed in the incidence of low cardiac output syndrome or acute kidney injury. No substantial safety concerns were noted, and toxic methaemoglobin levels were not observed. CONCLUSIONS Patients with baseline hypoxaemia undergoing cardiac surgery and receiving nitric oxide exhibited lower hypoxaemia rates and higher paO 2/FiO2 ratios. No significant differences were found regarding postoperative pulmonary complications and overall outcomes. TRIAL REGISTRATION This trial was registered at ClinicalTrials.gov (NCT04807413).

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Hipoxemia após revascularização miocárdica: análise dos fatores de risco

Cited by 34 publications

References 17 publications

Pulmonary complications in patients undergoing coronary artery bypass grafting at a hospital in Maceio, Brazil

Pulmonary complications in patients undergoing coronary artery bypass grafting at a hospital in Maceio, Brazil

Perfil ventilatório dos pacientes submetidos a cirurgia de revascularização do miocárdio

Effect of nitric oxide delivery via cardiopulmonary bypass circuit on postoperative oxygenation in adults undergoing cardiac surgery (NOCARD trial): a randomised controlled trial

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