Respiratory Complications After Coronary Artery Bypass Surgery With Unilateral or Bilateral Internal Mammary Artery Grafting

Daganou, Maria; Dimopoulou, Ioanna; Michalopoulos, Nikolaos; Papadopoulos, Konstantinos; Karakatsani, Anna; Geroulanos, S; Tzelepis, George E.

doi:10.1378/chest.113.5.1285

Cited by 54 publications

(29 citation statements)

References 24 publications

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“…According to some authors, postoperative hemorrhage was associated with complications like cerebrovascular accident, low cardiac output, pleural effusion, cardiac tamponade and coagulopathy (2) . In another study, the frequency of pneumothorax as a respiratory complication after coronary artery bypass graft corresponded to 5.3% (27) , higher than what the authors found (2.6%).…”

Section: Discussionmentioning

confidence: 57%

Circulação extracorpórea e complicações no período pós-operatório imediato de cirurgias cardíacas

Torrati

Dantas

2012

Acta paul. enferm.

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Objectives: To compare the frequency of complications presented by patients during the immediate postoperative period (IPP) for cardiac surgery, based on the time of extracorporeal circulation (ECC). Methods: A quantitative, descriptive and correlational study with 83 adult patients, divided into two groups according to the time of ECC. Results: Of the total patients, 44 (53%) had an ECC duration of up to 85 minutes, and 39 (47%) had a time of over 85 minutes. Complications were common in both groups, with the most frequent being pain and oliguria. However, hemothorax, pneumothorax, and acute myocardial infarction occurred only in the group with the longer duration of ECC. Conclusion:The majority of IPP complications presented in similar frequency for patients, independent of ECC time. Keywords: Nursing care; Thoracic surgery; Postoperative care rEsumo Objetivos: Comparar a frequência de complicações apresentadas pelos pacientes, durante o pós-operatório imediato (POI), de cirurgias cardíacas de acordo com o tempo de circulação extra-corpórea (CEC). Métodos: Estudo de natureza quantitativa, descritivo e correlacional com 83 pacientes adultos divididos em dois grupos de acordo com o tempo de CEC. Resultados: Do total de pacientes, 44 (53%) tiveram o tempo de duração da CEC de até 85 minutos e 39 (47 %) tiveram o tempo acima de 85 minutos. As complicações foram comuns para ambos os grupos, sendo as mais frequentes dor e oligúria. No entanto, hemotórax, pneumotórax e infarto agudo do miocárdio ocorreram apenas no grupo com maior tempo de CEC. Conclusão: A maioria das complicações ocorridas no POI apresentou frequencia semelhante para os pacientes, independente do tempo de CEC. Descritores: Cuidados de enfermagem; Cirurgia torácica; Cuidados pós-operatórios rEsumEn Objetivos: Comparar la frecuencia de complicaciones presentadas por los pacientes, durante el post-operatorio inmediato (POI), de cirugías cardíacas de acuerdo con el tiempo de circulación extra-corpórea (CEC). Métodos: Estudio de naturaleza cuantitativa, descriptiva y correlacional realizado con 83 pacientes adultos divididos en dos grupos de acuerdo con el tiempo de CEC. Resultados: Del total de pacientes, 44 (53%) tuvieron el tiempo de duración de la CEC de hasta 85 minutos y 39 (47 %) tuvieron el tempo encima de 85 minutos. Las complicaciones fueron comunes para ambos grupos, siendo las más frecuentes dolor y oliguria. Entre tanto, hemotórax, pneumotórax e infarto agudo del miocardio ocurrieron en el grupo con mayor tiempo de CEC. Conclusión: La mayoría de las complicaciones ocurridas en el POI presentó frecuencia semejante para los pacientes, independiente del tiempo de CEC.

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Section: Discussionmentioning

confidence: 57%

Circulação extracorpórea e complicações no período pós-operatório imediato de cirurgias cardíacas

Torrati

Dantas

2012

Acta paul. enferm.

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“…Hurlbut et al 11 reported with the same methodology an incidence of nearly 50% on day 2, decreasing to approximately 40% six days after the surgery. Recently, Daganou et al 20 reported evidence of atelectasis on chest radiographs in 51% of patients on the first postoperative day and in 25% on the fourth postoperative day. However, in the present study as well as in the study by Gale et al 21 , there was no a clear relationship between the presence of atelectasis and the development of effusion.…”

Section: Discussionmentioning

confidence: 99%

Acute pleuropulmonary complications detected by computed tomography following myocardial revascularization

et al. 2002

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INTRODUCTION:Pleuropulmonary changes are common following coronary artery bypass grafting surgery performed with a saphenous vein graft, with or without an internal mammary artery. The presence of atelectasis or pleural effusions reflects the thoracic trauma.PURPOSE: To define the postoperative incidence of changes in the lung and in the pleural space and to evaluate the influence of the trauma.METHODS: Thirty patients underwent elective coronary artery bypass grafting surgery (8 saphenous vein grafts and 22 saphenous vein grafts and internal mammary artery grafts with pleurotomy). Chest tubes in the left pleural space were used in all internal mammary artery patients. On the second (day 2) and seventh (day 7) postoperative day, patients underwent a computed tomography, and pleural effusions were rated as follows: grade 0 = no fluid to grade 4 = fluid in more than 75% of the hemithorax. Atelectasis was rated as follows: laminar = 1, segmental = 3, and lobar = 10 points.RESULTS: All patients had pleural effusion or atelectasis. Between day 2 and day 7, the number of patients with effusions or atelectasis on the right side decreased (P < 0.05). The incidence of effusions on day 2 in the saphenous vein graft group (87.5%) was higher (P < 0.05) than in the internal mammary artery group (52.3%). The incidence of atelectasis in the lower right lobe decreased (P < 0.05) from 86.7% (day 2) to 26.7% (day 7). The degree of atelectasis in both sides did not differ on day 2 (P = 0.42) but did on day 7 (P < 0.0001). There was a decrease in the atelectasis from day 2 to day 7 on the right side (P < 0.001), but not on the left (P = 0.21). On day 2 there was a relationship between atelectasis and effusion on the right (P = 0.04), but not on the left (P = 0.113).CONCLUSION: The present series demonstrates that there is a high incidence of both minimal pleural effusion and atelectasis after coronary artery bypass grafting surgery, which drops on the right side from day 2 to day 7 post surgery. Factors that contribute to the persistence of changes on the left side include the thoracic trauma and the presence of chest tubes and pericardial effusion.

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“…Age superior to 70 years old, productive cough, diabetes mellitus, smoking history, chronic obstructive pulmonary disease, obesity and previous reduction of pulmonary function are considered as risk factors for the development of postoperative PC 3 . Likewise, transoperatory factors, such as general anesthesia, pulmonary modifications after extracorporeal circulation (ECC), utilization of internal mammary artery as well as postoperative pain, are factors that contribute with the occurrence of PC [4][5][6][7][8] . Follow-up studies on pulmonary function and capacity after cardiac surgeries demonstrated that the volumes did not recover the preoperative values eight weeks after the surgery 9 .…”

Section: Introductionmentioning

confidence: 99%

Espirometria de incentivo com pressão positiva expiratória é benéfica após revascularização miocardio

Ferreira¹,

Haeffner²,

Barreto³

et al. 2010

Arq. Bras. Cardiol.

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Respiratory Complications After Coronary Artery Bypass Surgery With Unilateral or Bilateral Internal Mammary Artery Grafting

Cited by 54 publications

References 24 publications

Circulação extracorpórea e complicações no período pós-operatório imediato de cirurgias cardíacas

Circulação extracorpórea e complicações no período pós-operatório imediato de cirurgias cardíacas

Acute pleuropulmonary complications detected by computed tomography following myocardial revascularization

Espirometria de incentivo com pressão positiva expiratória é benéfica após revascularização miocardio

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