Ricerca avanzata

Home > Riviste > The Journal of Cardiovascular Surgery > Fascicoli precedenti > The Journal of Cardiovascular Surgery 2002 Agosto;43(4) > The Journal of Cardiovascular Surgery 2002 Agosto;43(4):419-22

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 2002 Agosto;43(4):419-22

CARDIAC SECTION 

 ORIGINAL ARTICLES

Peripheral pulmonary atelectasis and oxygentation impairment following coronary artery bypass grafting

Ishikawa S., Takahashi T., Ohtaki A., Sato Y., Suzuki M., Hasegawa Y., Ohki S., Mohara J., Oshima K., Morishita Y.

Second Department of Surgery, Gunma University School of Medicine, Maebashi, Japan

Background. Severe pul­mo­nary oxy­gen­a­tion impair­ment ­occurred in ­some ­patients ­with pleu­rot­o­my dur­ing the har­vest of the inter­nal mam­mary ­artery ­graft fol­lowed by cor­o­nary ­artery ­bypass graft­ing (­CABG). Peripheral pul­mo­nary ate­lec­ta­sis in the post­op­er­a­tive ­chest X-ray was detect­ed in ­these ­patients. We stud­ied the effi­ca­cy of intra­op­er­a­tive pos­i­tive end-expir­a­to­ry air­way pres­sure (­PEEP) ther­a­py for the pre­ven­tion of post­op­er­a­tive pul­mo­nary oxy­gen­a­tion impair­ment.
Methods. The pleu­ral cav­ity was intra­op­er­a­tive­ly ­opened in 40 ­patients ­with sol­i­tary ­CABG pro­ce­dure per­formed dur­ing 5 ­years ­since January 1992. These ­patients ­were divid­ed ­into two ­groups. Intraoperative ­PEEP ther­a­py, ­which is initiat­ed ­just ­after pleu­rot­o­my, was not ­used in 32 ­patients ­before May, 1996 (con­trol ­group) and ­used for ­recent 8 ­patients ­with pleu­rot­o­my (­PEEP ­group). The ­mean age of ­patients was 60 ­years old in the con­trol ­group and 68 in the ­PEEP ­group.
Results. Respiratory insuf­fi­cien­cy (A-aDO2 >400 mmHg and RI >1.5) was detect­ed in 6 ­patients in the con­trol ­group. Three out of ­these 6 ­patients ­required ­long-­term mechan­i­cal res­pir­a­to­ry sup­port ­over a ­week. No res­pir­a­to­ry insuf­fi­cien­cy ­occurred in ­patients of the PEEP group. Values of PaO2, A-aDO2, res­pir­a­to­ry ­index and ­shunt ­ratio ­were sig­nif­i­cant­ly ­worse in the con­trol ­group ­than in the ­PEEP ­group.
Conclusions. In con­clu­sion, ­PEEP ther­a­py may pre­vent pul­mo­nary ate­lec­ta­sis and oxy­gen impair­ment ­after ­CABG.

lingua: Inglese


FULL TEXT  ESTRATTI

inizio pagina