The Influence of Cardiopulmonary By-pass on Respiratory Function in Patients Who Underwent Coronary Disease Surgery

Abstract

The study is designed to show influence of cardiopulmonary by-pass (CPB) on respiratory function in patients who underwent cardiac surgery. Patients and methods: With respect on operative technique the patients were divided into two groups consisted of 40 patients, who underwent with or without CPB. On the bases of the hemodynamic measurements and counting alveolar arterial oxygen difference (A-a)DO2, saturation of mixed venous blood (SvO2), direct intrapulmonary shunt (V/Q) and hypoxemic score (PaO 2 /FiO2) preoperative and postoperative respiratory function in these patients is assumed. There were one preoperative and four postoperative measurements. Results and discussion: Statistically significant difference is found between the examined groups between mean values of alveolar arterial oxygen difference (A-a)DO2 in three postoperative measurements (p=0,035, p=0,015 and p=0,011), direct intrapulmonary shunt (V/Q) in four postoperative measurements (p=0,037, p=0,023, p=0,014 and p=0,04), saturation of mixed venous blood (SvO 2 ) in four postoperative measurements (p=0,01, p=0,023, p=0,020 and p=0,020) and hypoxemic score (PaO 2 /FO 2 ) in four postoperative measurements (p=0,018, p=0,028, p=0,017 and p=0,038). The comparative analyses of parameters of respiratory function in both groups showed increased degree of acute lung injury (ALI) in group of patients underwent CPB. Conclusion: Early discovering parameters of acute lung injury in early postoperative period in patients underwent cardiac surgery with cardiopulmonary by-pass can prevent development of postoperative complications and duration of hospitalization.

Impact of Lung Expansion Therapy Using Positive End-Expiratory Pressure in Mechanically Ventilated Patients Submitted to Coronary Artery Bypass Grafting

“…In this sense, the lung expansion therapy (LET) is an interesting alternative to reestablish the gas exchanges and, consequently, normalize the oxygenation [5,6] . The application of positive end-expiratory pressure (PEEP) is well established for this purpose, but the pressure required to correct hypoxemia is still questioned.…”