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FASCICOLI E ARTICOLI   I PIÙ LETTI   eTOC

ULTIMO FASCICOLOTHE 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
Impact Factor 1,632

Periodicità: Bimestrale

ISSN 0021-9509

Online ISSN 1827-191X

 

The Journal of Cardiovascular Surgery 1998 Dicembre;39(6):777-81

CARDIAC PAPERS 

 ORIGINAL ARTICLES

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.

lingua: Inglese


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