TITLE

Comparison of Pulmonary Gas Exchange in OPCAB Versus Conventional CABG

AUTHOR(S)
Syed, Aitizaz; Fawzy, Hosam; Farag, Atef; Nemlander, Arto
PUB. DATE
June 2004
SOURCE
Heart, Lung & Circulation;Jun2004, Vol. 13 Issue 2, p168
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background. Cardiopulmonary bypass has been implicated as a cause of acute lung injury in cardiac surgical patients. This could be avoided with off-pump coronary artery bypass surgery.Aim. To ascertain the possible benefit of OPCAB surgery on pulmonary gas exchange.Methods. We randomized 75 consecutive patients (mean age 57 years) into two groups: Group 1 off-pump coronary artery bypass surgery (OPCAB), n=37, Group 2 conventional coronary artery bypass grafting (con CABG), n=38. Alveolar-arterial oxygen difference (A-aO2 difference) was calculated pre-operatively, then 2 and 4 h post-operatively. PaO2/FiO2 ratio and respiratory index (RI) were calculated 2 and 4 h post-operatively.Results. Alveolar-arterial O2 gradient sharply increased in the immediate post-operative period, from 27 mmHg pre-operatively, to 227 mmHg 2 h post-operatively, then declined to 152 mmHg 4 h post-operatively. PaO2/FiO2 ratio and RI also showed severe worsening 2 h post-operatively, with marked improvement at 4 h. The pattern of physiological deterioration of gas exchange was similar in both the groups.Conclusion. In terms of pulmonary gas exchange, similar degree of deterioration is noticed in CABG patients with or without cardiopulmonary bypass. OPCAB seems to provide no physiological benefit of gas exchange at the alveolar capillary membrane when compared to conventional CABG.
ACCESSION #
18882517

 

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