Pulmonary Complications of Cardiac Surgery

Tanner, Tristan; Colvin, Mai

doi:10.1007/s00408-020-00405-7

Cited by 52 publications

(40 citation statements)

References 70 publications

(77 reference statements)

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“…A full sternotomy was performed from the sternal notch to the xiphoid process. The definitions of the postoperative outcomes mainly depend on the descriptions mentioned in the original articles ( 8 , 18 , 39 , 43 – 45 ). Besides postoperative pulmonary complications were defined as complications occurring in the postoperative period and producing clinical diseases, such as pneumonia, pleural effusion, pneumothorax, pulmonary infection, and respiratory insufficiency (defined as the need for reintubation or tracheostomy after initial extubation), and prolonged ventilation time, which was defined as mechanical ventilatory support requirement for more than 24 h. Pulmonary function tests, represented by FEV1, TLC, and FVC, were assessed based on a spirometry test 1 week after surgery.…”

Section: Methodsmentioning

confidence: 99%

RETRACTED: Comparative Evaluation of the Incidence of Postoperative Pulmonary Complications After Minimally Invasive Valve Surgery vs. Full Sternotomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Propensity Score-Matched Studies

Mohamed

Ding

Shah

et al. 2021

Front. Cardiovasc. Med.

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Background: Postoperative pulmonary complications remain a leading cause of increased morbidity, mortality, longer hospital stays, and increased costs after cardiac surgery; therefore, our study aims to analyze whether minimally invasive valve surgery (MIVS) for both aortic and mitral valves can improve pulmonary function and reduce the incidence of postoperative pulmonary complications when compared with the full median sternotomy (FS) approach.Methods: A comprehensive systematic literature research was performed for studies comparing MIVS and FS up to February 2021. Randomized controlled trials (RCTs) and propensity score-matching (PSM) studies comparing early respiratory function and pulmonary complications after MIVS and FS were extracted and analyzed. Secondary outcomes included intra- and postoperative outcomes.Results: A total of 10,194 patients from 30 studies (6 RCTs and 24 PSM studies) were analyzed. Early mortality differed significantly between the groups (MIVS 1.2 vs. FS 1.9%; p = 0.005). Compared with FS, MIVS significantly lowered the incidence of postoperative pulmonary complications (odds ratio 0.79, 95% confidence interval [0.67, 0.93]; p = 0.004) and improved early postoperative respiratory function status (mean difference −24.83 [−29.90, −19.76]; p < 0.00001). Blood transfusion amount was significantly lower after MIVS (p < 0.02), whereas cardiopulmonary bypass time and aortic cross-clamp time were significantly longer after MIVS (p < 0.00001).Conclusions: Our study showed that minimally invasive valve surgery decreases the incidence of postoperative pulmonary complications and improves postoperative respiratory function status.

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Section: Methodsmentioning

confidence: 99%

RETRACTED: Comparative Evaluation of the Incidence of Postoperative Pulmonary Complications After Minimally Invasive Valve Surgery vs. Full Sternotomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Propensity Score-Matched Studies

Mohamed

Ding

Shah

et al. 2021

Front. Cardiovasc. Med.

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“…The top three incidences of PPCs in our study were pleural effusion, atelectasis, and pulmonary infection, which is consistent with the results of a previous study [ 17 ], while that in the PROVECS trial were respiratory failure, respiratory acidosis, and radiological atelectasis [ 2 ]. The surgical type in our study is mainly valvular procedure (over 80%) due to rheumatic heart disease, which is much higher than the PROVECS’s.…”

Section: Discussionsupporting

confidence: 92%

Effect of ventilation strategy during cardiopulmonary bypass on postoperative pulmonary complications after cardiac surgery: a randomized clinical trial

Zhang

Liao

et al. 2021

J Cardiothorac Surg

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Background To determine whether maintaining ventilation during cardiopulmonary bypass (CPB) with a different fraction of inspired oxygen (FiO2) had an impact on the occurrence of postoperative pulmonary complications (PPCs). Methods A total of 413 adult patients undergoing elective cardiac surgery with CPB were randomly assigned into three groups: 138 in the NoV group (received no mechanical ventilation during CPB), 138 in the LOV group (received a tidal volume (VT) of 3–4 ml/kg of ideal body weight with the respiratory rate of 10–12 bpm, and the positive end-expiratory pressure of 5–8 cmH2O during CPB; the FiO2 was 30%), and 137 in the HOV group (received the same ventilation parameters settings as the LOV group while the FiO2 was 80%). Results The primary outcomes were the incidence and severity of PPCs during hospitalization. The composite incidence of PPCs did not significantly differ between the NoV (63%), LOV (49%) and HOV (57%) groups (P = 0.069). And there was also no difference regarding the incidence of PPCs between the non-ventilation (NoV) and ventilation (the combination of LOV and HOV) groups. The LOV group was observed a lower proportion of moderate and severe pulmonary complications (grade ≥ 3) than the NoV group (23.1% vs. 44.2%, P = 0.001). Conclusion Maintaining ventilation during CPB did not reduce the incidence of PPCs in patients undergoing cardiac surgery. Trial registration: Chinese Clinical Trial Registry ChiCTR1800015261. Prospectively registered 19 March 2018. http://www.chictr.org.cn/showproj.aspx?proj=25982

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“…Given the importance of knowing the impact of these tools, this review aimed to determine the impact of clinical decision systems on cardiac patients in ICUs. The specific objectives were: (1) to examine and describe the evolution, detection of medical complications, interventions, and treatment response in the postoperative period of cardiac surgery; (2) to describe the rating and satisfaction of health professionals regarding the use of decision systems in ICUs.…”

Section: Objectivesmentioning

confidence: 99%

“…These patients are likely to experience complications during the postoperative period. Cardiogenic shock (CS), low cardiac output syndrome (LCOS), stroke, kidney failure, gastrointestinal problems, and respiratory distress are the main issues that may arise during this period, entailing the highest mortality [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Applicability of Clinical Decision Support in Management among Patients Undergoing Cardiac Surgery in Intensive Care Unit: A Systematic Review

et al. 2021

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The advances achieved in recent decades regarding cardiac surgery have led to a new risk that goes beyond surgeons' dexterity; postoperative hours are crucial for cardiac surgery patients and are usually spent in intensive care units (ICUs), where the patients need to be continuously monitored to adjust their treatment. Clinical decision support systems (CDSSs) have been developed to take this real-time information and provide clinical suggestions to physicians in order to reduce medical errors and to improve patient recovery. In this review, an initial total of 499 papers were considered after identification using PubMed, Web of Science, and CINAHL. Twenty-two studies were included after filtering, which included the deletion of duplications and the exclusion of titles or abstracts that were not of real interest. A review of these papers concluded the applicability and advances that CDSSs offer for both doctors and patients. Better prognosis and recovery rates are achieved by using this technology, which has also received high acceptance among most physicians. However, despite the evidence that well-designed CDSSs are effective, they still need to be refined to offer the best assistance possible, which may still take time, despite the promising models that have already been applied in real ICUs.

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Pulmonary Complications of Cardiac Surgery

Cited by 52 publications

References 70 publications

RETRACTED: Comparative Evaluation of the Incidence of Postoperative Pulmonary Complications After Minimally Invasive Valve Surgery vs. Full Sternotomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Propensity Score-Matched Studies

RETRACTED: Comparative Evaluation of the Incidence of Postoperative Pulmonary Complications After Minimally Invasive Valve Surgery vs. Full Sternotomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Propensity Score-Matched Studies

Effect of ventilation strategy during cardiopulmonary bypass on postoperative pulmonary complications after cardiac surgery: a randomized clinical trial

Applicability of Clinical Decision Support in Management among Patients Undergoing Cardiac Surgery in Intensive Care Unit: A Systematic Review

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