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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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ORIGINAL ARTICLES CARDIAC PAPERS
The Journal of Cardiovascular Surgery 1998 Dicembre;39(6):777-81
Adult respiratory distress syndrome following cardiopulmonary bypass: incidence, prophylaxis and management
Kaul T. K., Fields B. L., Riggins L. S., Wyatt D. A., Jones Ch. R., Nagle D.
From the Department of Cardiac Surgery, Baptist Medical Center, Birmingham, Alabama, USA
Background. In this retrospective study, we have examined the incidence and the predictors of ARDS (adult respiratory distress syndrome), in patients undergoing coronary artery bypass (CABG) surgery on cardiopulmonary bypass (CPB). The prophylactic and therapeutic measures that were used in this series were also evaluated.
Methods. Between January 1988 and January 1995, 4318 consecutive patients undergoing an isolated and a primary CABG procedure were included. Patients with poor left ventricular function, congestive heart failure (CHF), renal failure and with an abnormal chest radiogram were excluded.
Results. The independent predictors of ARDS were: recent cigarette smoking, advanced COPD (chronic obstructive pulmonary disease) and emergency surgery. The overall incidence of ARDS was 2.5% and hospital mortality in patients with an established ARDS was 27.7% (30/108). The prophylactic and the therapeutic measures which have been used in this series had no significant impact on the incidence and hospital mortality.
Conclusions. In view of a high perioperative mortality in patients with established ARDS, a mandate for a regular use of prophylactic and therapeutic measures that are based on its pathophysiology, clearly exists.