الفهرس | Only 14 pages are availabe for public view |
Abstract Pulmonary complications are common after cardiac surgery with increased mortality rates. Pulmonary complications after cardiac surgery recorded incidence of 25% of all cardiac surgeries. Pulmonary complications after cardiac surgery included in atelectasis, pleural effusion, pulmonary embolism, pneumonia, pulmonary edema and phrenic nerve injury. Impairment of gas exchange is reflected by reduction in oxygenation and in hypoxic index (PaO2/FiO2). Pathophysiology of postoperative pulmonary complications is multifactorial including inflammatory response to CPB, stopping ventilation during CPB, blood transfusion and hyperoxia. There are multiple strategies for intervention to decrease the rate of incidence of these complications and these strategies including pharmaceutical route, leukocyte depletion, ultrafiltration, heparinization of the artificial circuit and maintaining ventilation during CPB. There are multiple strategies for maintaining ventilation during CPB including application of PEEP, C-PAP, low tidal volume ventilation and application of recruitment maneuvers. The recent study included one of these RMs and we conclude that application of alveolar recruitment strategy showed short term improvement in the arterial oxygenation and ventilation perfusion mismatch in patients undergoing CABG using CPB. |