Incidence and risk factors of Pulmonary Complications after Cardiopulmonary bypass.

Autor: Naveed A; Dr. Anjum Naveed, (FCPS). Assistant Professor of Pulmonology, CPE Institute of Cardiology, Multan, Pakistan., Azam H; Hammad Azam, (FCPS Surgery). Assistant Professor of Cardiac Surgery, Sheikh Zayed Medical College and Hospital, Rahim Yaar Khan, Pakistan., Murtaza HG; Humayoun Ghulam Murtaza, (DTCD, FCPS). Senior Registrar Pulmonology, Nishtar Medical College/Hospital, Multan, Pakistan., Ahmad RA; Rana Altaf Ahmad, (DA, FCPS, M. Sc. Pain Medicine). Professor of Anesthesia and Critical Care, Executive Director, CPE Institute of Cardiology, Multan, Pakistan., Baig MAR; Mirza Ahmad Raza Baig, (BSc. Hons. CPT). Clinical Perfusionist, CPE Institute of Cardiology, Multan, Pakistan.
Jazyk: angličtina
Zdroj: Pakistan journal of medical sciences [Pak J Med Sci] 2017 Jul-Aug; Vol. 33 (4), pp. 993-996.
DOI: 10.12669/pjms.334.12846
Abstrakt: Objective: To determine the frequency of post-operative pulmonary complications (PPCs) after cardio-pulmonary bypass and association of pre-operative and intraoperative risk factors with incidence of PPCs.
Methods: This study was an observational analysis of five hundred and seventeen (517) patients who underwent cardiac surgery using cardiopulmonary bypass. Incidence of PPCs and risk factors of PPCs were noted. Logistic regression was applied to determine the association of pre-operative and intraoperative risk factors with incidence of PPCs.
Results: Post-operative pulmonary complications occurred in 32 (6.2%) patients. Most common post-operative pulmonary complication was atelectasis that occurred in 20 (3.86%) patients, respiratory failure in 8 (1.54%) patients, pneumonia in 3 (0.58%) patients and acute respiratory distress syndrome in 1 (0.19%) patients. The main risk factor of PPCs were advance age ≥ 60 years [odds ratio 4.16 (1.99-8.67), p-value <0.001], prolonged CPB time > 120 minutes [odds ratio 3.62 (1.46-8.97) p-value 0.003], pre-op pulmonary hypertension [odds ratio 2.60 (1.18-5.73), p-value 0.016] and intraoperative phrenic nerve injury [odds ratio 7.06 (1.73-28.74), p-value 0.002]. Operative mortality was 9.4% in patients with PPCs and 1.0% in patients without PPCs (p-value 0.01).
Conclusion: The incidence of post-operative pulmonary complications was 6.2% in this study. Advanced age (age ≥ 60 years), prolonged CPB time (CPB time > 120 minutes), pre-op pulmonary hypertension and intraoperative phrenic nerve injury are independent risk factors of PPCs after surgery.
Competing Interests: Declaration of interest: None.
Databáze: MEDLINE
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