DISORDERS OF EXTERNAL RESPIRATION AND THEIR IMPACT ON THE CLINICAL OUTCOME IN THE PATIENTS UNDERGOING CARDIAC SURGERY

• Main Authors: D. N. Ponomarev, O. V. Kamenskaya, A. S. Klinkova, I. Yu. Loginova, I. A. Kornilov, V. A. Shmyrev, V. V. Lomivorotov
• Format: Article
• Language: Russian
• Published: NEW TERRA Publishing House 2018-01-01
• Series: Вестник анестезиологии и реаниматологии
• Subjects: obstructive pattern; restrictive pattern; external respiration pattern; forced expiratory volume per 1 second; forced vital lung capacity; cardiac surgery
• Online Access: https://www.vair-journal.com/jour/article/view/124

Goal: to investigate the frequency and specific features of respiratory disorders and their impact on the clinical course in the patients having coronary artery bypass graft operation. Materials. 454 patients expecting coronary artery bypass graft operation were enrolled into the prospective cohort study. External respiration function was evaluated prior to the surgery. Pathologic respiration patterns were assessed basing on forced expiratory volume per 1 second (FEV1 ) and forced vital lung capacity (FVLC). The pattern was evaluated as obstructive with the ratio of FEV1 /FVLC < 0.70; and the restrictive pattern was the combination of FEV1 /FVLC≥ 0.70 and FVLC < 80% of "must". Results. Obstructive and restrictive patterns were detected in 72 (15.8%) and 50 (11.0%) patients respectively. Out of 133 patients with compromised external respiration function chronic obstructive pulmonary disease was diagnosed only in 26 patients. Bronchial obstruction was related to the risk of auricular fibrillation, increase of duration of artificial pulmonary ventilation and prolonged hospital stay. Conclusion. It has been demonstrated that it is possible to improve clinical outcomes in the patients undergoing cardiac surgery through diagnostics of respiratory disorders, detection of risk groups and prevention of complications.