ORIGINAL ARTICLES  CARDIAC SECTION 

The Journal of Cardiovascular Surgery 2010 December;51(6):935-9

Copyright © 2010 EDIZIONI MINERVA MEDICA

lingua: Inglese

Pleural opening impairs respiratory system compliance and resistance in off-pump coronary artery bypass grafting

Tavolaro K. C. ¹, Guizilini S. ¹, Bolzan D. W. ¹, Dauar R. B. ², Buffolo E. ¹, Succi J. E. ², Gomes W. J. ¹ ✉

¹ Cardiovascular Surgery Discipline, Federal University of São Paulo, San Paolo, Brazil; ² Cardiovascular Surgery Division, Bandeirantes Hospital, San Paolo, Brazil

AIM: This study evaluated the effect of pleurotomy on respiratory system compliance and resistance in off-pump coronary artery bypass (OPCAB) using the left internal thoracic artery (LITA).
METHODS: Thirty-two patients were prospectively allocated into two groups: OP group (n=16 patients with open left pleural cavity); IP group (N.=16 patients with intact pleural cavity). Static and dynamic lung compliance and total respiratory system resistance calculation were recorded at anesthesia induction (before chest opening) and immediately after chest closure.
RESULTS: Static lung compliance values significantly decreased after chest closure in both groups (P<0.0001), but the OP group had a significantly greater decline (P=0.0007). Dynamic lung compliance decreased in either groups after chest closure (P<0.0001), however, no significant difference was found between groups (P=0.228). Total respiratory system resistance increased in both groups (P<0.05), however the OP group had a higher increase (P=0.0005). Orotracheal intubation time (P=0.041) and hospital stay (P=0.0004) were higher in the OP group.
CONCLUSION: Pleura opening and need of chest tube insertion induced significant reduction in static lung compliance and increase in total respiratory system resistance, furthermore contributing to impair pulmonary dysfunction in the early postoperative period after OPCAB.