Intrapulmonary shunt after cardiopulmonary bypass: The use of vital capacity maneuvers versus off-pump coronary artery bypass grafting
| Autor: | Bernhard Partik, Walter Klimscha, Marek P. Ehrlich, Ursula Jantsch, Klaus Kubin, Franz P. Keznickl, Anton Bambazek, Wilfried Wisser, Michael Grimm, Edda M. Tschernko |
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| Rok vydání: | 2002 |
| Předmět: |
Pulmonary and Respiratory Medicine
Pulmonary Atelectasis medicine.medical_specialty medicine.medical_treatment Coronary Disease Atelectasis Heart-Lung Machine law.invention Hypoxemia Coronary artery bypass surgery law Internal medicine medicine Cardiopulmonary bypass Humans Prospective Studies Derivation Coronary Artery Bypass Aged Off-pump coronary artery bypass Cardiopulmonary Bypass Pulmonary Gas Exchange business.industry Hemodynamics Length of Stay Middle Aged medicine.disease Shunting Treatment Outcome medicine.anatomical_structure Anesthesia Cardiology Surgery medicine.symptom Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 124:732-738 |
| ISSN: | 0022-5223 |
| DOI: | 10.1067/mtc.2002.124798 |
| Popis: | Objectives: It has been proved in human subjects and animals that atelectasis is a major cause of intrapulmonary shunting and hypoxemia after cardiopulmonary bypass. Animal studies suggest that shunting can be prevented entirely by a total vital capacity maneuver performed before termination of bypass. This study aimed to test this theory in human subjects and to evaluate possible advantages of off-pump coronary artery bypass grafting. Methods: Twenty-four patients scheduled for coronary artery bypass grafting were randomly assigned to receive no total vital capacity maneuver (control group, n = 12) or standard total vital capacity maneuvers (TVCM group, n = 12). Additionally, 12 consecutive patients undergoing off-pump coronary artery bypass grafting (off-pump group) were studied. Systemic and central hemodynamics, the pattern of breathing, and ventilatory mechanics were evaluated after induction of anesthesia, after sternotomy, after cardiopulmonary bypass and skin closure, and 4 hours after extubation. Results: The use of total vital capacity maneuvers reduced (P |
| Databáze: | OpenAIRE |
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