Postoperative Pulmonary Complications After Cardiac Surgery: The VENICE International Cohort Study.

Autor: Fischer MO; Normandie Univ, UNICAEN, CHU de Caen Normandie, Service d'Anesthésie Réanimation, Caen, France. Electronic address: fischer-mo@chu-caen.fr., Brotons F; Department of Biostatistics and Clinical Research, Caen University Hospital, CAEN, France., Briant AR; Department of Biostatistics and Clinical Research, Caen University Hospital, CAEN, France., Suehiro K; Department of Anesthesiology, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka City, Osaka, Japan., Gozdzik W; Department of Anesthesiology and Intensive Therapy, Wrocław Medical University, Wrocław, Poland., Sponholz C; Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany., Kirkeby-Garstad I; Department of Anesthesiology and Intensive Care, St. Olav University Hospital, Trondheim, Norway., Joosten A; Department of Anesthesiology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium., Nigro Neto C; Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil., Kunstyr J; Department of Anesthesiology and Intensive Care, First Faculty of Medicine, Charles University in Prague, and General University Hospital in Prague, Prague, The Czech Republic., Parienti JJ; Department of Biostatistics and Clinical Research, Caen University Hospital, CAEN, France., Abou-Arab O; Anesthesia and Critical Care department, Amiens, Hospital University, Amiens, France., Ouattara A; Anesthesia and Critical Care department, Amiens, Hospital University, Amiens, France.
Jazyk: angličtina
Zdroj: Journal of cardiothoracic and vascular anesthesia [J Cardiothorac Vasc Anesth] 2022 Aug; Vol. 36 (8 Pt A), pp. 2344-2351. Date of Electronic Publication: 2021 Dec 25.
DOI: 10.1053/j.jvca.2021.12.024
Abstrakt: Objective: Postoperative pulmonary complications (PPC) remain a main issue after cardiac surgery. The objective was to report the incidence and identify risk factors of PPC after cardiac surgery.
Design: An international multicenter prospective study (42 international centers in 9 countries).
Participants: A total of 707 adult patients who underwent cardiac surgery under cardiopulmonary bypass.
Interventions: None MEASUREMENTS AND MAIN RESULTS: During a study period of 2 weeks, the investigators included all patients in their respective centers and screened for PPCs. PPC was defined as the occurrence of at least 1 pulmonary complication among the following: atelectasis, pleural effusion, respiratory failure, respiratory infection, pneumothorax, bronchospasm, or aspiration pneumonitis. Among 676 analyzed patients, 373 patients presented with a PPC (55%). The presence of PPC was significantly associated with a longer intensive care length of stay and hospital length of stay. One hundred ninety (64%) patients were not intraoperatively ventilated during cardiopulmonary bypass. Ventilation settings were similar regarding tidal volume, respiratory rate, inspired oxygen. In the regression model, age, the Euroscore II, chronic obstructive pulmonary disease, preoxygenation modality, intraoperative positive end-expiratory pressure, the absence of pre- cardiopulmonary bypass ventilation, the absence of lung recruitment, and the neuromuscular blockade were associated with PPC occurrence.
Conclusion: Both individual risk factors and ventilatory settings were shown to explain the high level of PPCs. These findings require further investigations to assess a bundle strategy for optimal ventilation strategy to decrease PPC incidence.
Competing Interests: Conflict of Interest None.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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