Off-pump versus on-pump coronary artery bypass surgery and postoperative pulmonary dysfunction

Objective: To investigate how off-pump coronary artery bypass grafting (CABG) affects postoperative pulmonary function when compared with on-pump CABG. Design: Prospective clinical study. Setting: University-affiliated teaching hospital. Participants: Adult patients (n = 39) undergoing elective coro...

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Autores:
Tipo de recurso:
Fecha de publicación:
2004
Institución:
Universidad del Rosario
Repositorio:
Repositorio EdocUR - U. Rosario
Idioma:
eng
OAI Identifier:
oai:repository.urosario.edu.co:10336/22274
Acceso en línea:
https://doi.org/10.1053/j.jvca.2004.08.004
https://repository.urosario.edu.co/handle/10336/22274
Palabra clave:
Adult
Aged
Arterial gas
Arterial oxygen tension
Article
Atelectasis
Cardiopulmonary bypass
Clinical article
Controlled study
Coronary artery bypass surgery
Elective surgery
Extubation
Human
Lung disease
Lung edema
Lung flow volume curve
Lung function
Lung function test
Lung volume
Off pump coronary surgery
Plethysmography
Pleura
Postoperative complication
Priority journal
Statistical significance
Teaching hospital
Thorax radiography
Blood gas analysis
Cardiopulmonary bypass
Coronary artery bypass
Humans
Lung
Lung diseases
Middle aged
Postoperative complications
Prospective studies
Respiratory function tests
Time factors
Coronary artery bypass grafting
Off-pump coronary artery bypass
Postoperative complications
Pulmonary function
off-pump
Coronary artery bypass
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Description
Summary:Objective: To investigate how off-pump coronary artery bypass grafting (CABG) affects postoperative pulmonary function when compared with on-pump CABG. Design: Prospective clinical study. Setting: University-affiliated teaching hospital. Participants: Adult patients (n = 39) undergoing elective coronary artery bypass surgery with or without cardiopulmonary bypass. Interventions: Two groups of patients were compared: 19 consecutive patients undergoing off-pump CABG surgery and 20 consecutive patients undergoing conventional CABG surgery. Measurements and Main Results: Pulmonary function tests (flow volume loops and lung volumes with plethysmography) were done preoperatively and 72 hours postoperatively. Arterial blood gases and PaO2/FIO 2 were measured at various stages. Sequential chest x-rays were obtained and evaluated for pleural changes, pulmonary edema, and atelectasis. In both groups, PaO2/FIO2 ratios decreased progressively throughout the perioperative period, with no significant differences between the groups at any stage during the study. There was a significant decline in postoperative pulmonary function tests in both groups, but there was no difference between groups at 72 hours postoperatively. No differences were found in the time to extubation, atelectasis scores, or postoperative complications. Conclusions: Off-pump CABG does not confer major protection from postoperative pulmonary dysfunction compared with CABG surgery with CPB. Strategies for minimizing pulmonary impairment after CABG surgery should be directed to factors other than the use of CPB. © 2004 Elsevier Inc. All rights reserved.