Adult respiratory distress syndrome after cardiac surgery

Christenson, Jan T.; Aeberhard, Judith; Badel, Pierre; Pepcak, F; Maurice, Jean; Simonet, F; Velebit, V; Schmuziger, M

doi:10.1016/0967-2109(96)83778-1

Cited by 130 publications

(101 citation statements)

References 25 publications

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“…Retrospective analyses have suggested that cigarette smoking may be associated with ALI, although these studies were limited by their use of nonspecific administrative data and insensitive measures of both smoking and ALI (5,6). In addition, experimental studies have demonstrated that active smoking causes pathophysiological changes similar to those seen in ALI, including increased lung epithelial permeability, endothelial injury, and disordered platelet function (7)(8)(9)(10)(11)(12).…”

mentioning

confidence: 99%

Active and Passive Cigarette Smoking and Acute Lung Injury after Severe Blunt Trauma

Calfee¹,

Matthay²,

Eisner³

et al. 2011

Am J Respir Crit Care Med

137

120

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Rationale: Cigarette smoking has been demonstrated in laboratory studies to have effects on lung epithelial and endothelial function similar to those observed in acute lung injury (ALI). However, the association between active and passive cigarette smoke exposure and susceptibility to ALI has not been prospectively studied. Objectives: We hypothesized that both active and passive cigarette smoke exposure would be associated with increased susceptibility to ALI after severe blunt trauma. Methods: We measured levels of cotinine, a metabolite of nicotine and validated biomarker of tobacco use, in plasma samples obtained immediately on arrival at the emergency department from 144 adult subjects after severe blunt trauma. Patients were then followed for the development of ALI. Measurements and Main Results: Increasing quartiles of plasma cotinine were associated with the development of ALI (odds ratio [OR] for developing ALI in highest cotinine quartile, 3.25; 95% confidence interval [CI], 1.22-8.68; P 5 0.017 for trend across quartiles). Moderate to heavy passive smoke exposure was associated with nearly the same odds of developing ALI as active smoking (OR for moderate to heavy passive smoking compared with no exposure or low level exposure, 3.03; 95% CI, 1.15-8.04; OR for active smoking, 2.77; 95% CI, 1. 28-5.99). This association persisted after adjusting for other predictors of ALI, including Injury Severity Score and alcohol abuse. Conclusions: Both moderate to heavy passive smoking and active smoking are independently associated with the development of ALI after severe blunt trauma. This finding has important implications both for public health and for understanding the pathogenesis of ALI.

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mentioning

confidence: 99%

Active and Passive Cigarette Smoking and Acute Lung Injury after Severe Blunt Trauma

Calfee¹,

Matthay²,

Eisner³

et al. 2011

Am J Respir Crit Care Med

137

120

View full text Add to dashboard Cite

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“…Grafts frequently become hypoxic postoperatively because hypoxemia commonly occurs in the patients after CABG surgery due to hypoventilation, atrial or ventricular arrhythmia, respiratory syndromes, etc. (Christenson et al, 1996;Willems et al, 1997;Tamis-Holland et al, 2000;Weiss et al, 2000). We have demonstrated that a mechanism independent of prostaglandins mediates relaxation of human IMA and RA to hypoxia, whereas vasoconstrictor prostaglandins impaired the relaxation and potentiated the contraction of IMA to hypoxia-reoxygenation.…”

Section: Downloaded Frommentioning

confidence: 81%

Role of Prostaglandins in Mediating Differences in Human Internal Mammary and Radial Artery Relaxation Elicited by Hypoxia

Gupte

Zias²,

Sarabu³

et al. 2004

J Pharmacol Exp Ther

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The effects of hypoxia-reoxygenation on internal mammary (IMA) and radial (RA) arteries used for coronary artery bypass grafting (CABG) were examined to identify mechanisms regulating contractile function and differences that could contribute to vasospasm. Isolated endothelium-intact IMA and RA rings precontracted with KCl (30 mM) rapidly dilated to hypoxia (95% N 2 /5% CO 2 ) with a greater relaxation in RA than IMA. Inhibitors of cyclooxygenase (10 M indomethacin) and the thromboxane A 2 (TxA 2 ) -29548)] potentiated the relaxation to hypoxia in IMA, but not RA, a response associated with increases in TxA 2 . Relaxation of IMA and RA to hypoxia appears to involve a calciumreuptake mechanism inhibited by cyclopiazonic acid (0.2 mM), and it was not attenuated by a blocker of potassium channels (10 mM TEA). The recovery of force generation of IMA, but not RA, upon reoxygenation after 30 min of hypoxia was significantly reduced in the initial phase of reoxygenation by indomethacin and SQ-29548 and by endothelin receptor blocker. Thus, hypoxia relaxes IMA and RA by a postaglandin-independent mechanism potentially involving enhanced intracellular calcium reuptake. The prostaglandinmediated alterations of responses to hypoxia-reoxygenation seen in IMA, but not in RA, may predispose IMA to vasospasm-related complications of CABG.

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“…14,15) Some investigators have suggested that a low postoperative cardiac output state gives rise to splanchnic hypoperfusion and mucosal ischemia which results in the translocation of endotoxins from the intestine into the circulation. [16][17][18] Recently, Christenson, et al 19) showed that hypertension was one of the independent risk factors for adult respiratory distress syndrome, characterized by high permeability pulmonary edema caused by endothelial damage. Patients with chronic hypertension are liable to develop hypoperfusion during CABG under ordinary pressure control.…”

Section: Discussionmentioning

confidence: 99%

Predictive Risk Factors for Pulmonary Oxygen Transfer in Patients Undergoing Coronary Artery Bypass Grafting.

et al. 2001

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SUMMARYThe ratio of arterial oxygen tension to inspired oxygen fraction (PaO 2 / FiO 2 ) is a useful indicator for weaning patients from mechanical ventilation and a reliable predictor of pulmonary dysfunction after cardiac surgery. The aim of this study was to elucidate the patient characteristics and variables that affect the PaO 2 / FiO 2 ratio.Between 1994-1998, 167 patients who underwent coronary artery bypass grafting (CABG) were examined retrospectively. Spearman's correlation coefficients were calculated between the PaO 2 / FiO 2 ratio and intubation period, and length of ICU stay. Patients were then divided into two groups with a PaO 2 / FiO 2 ratio < 350 and PaO 2 / FiO 2 ratio ≥ 350. Univariate analysis of the putative risk factors was performed. A logistic regression model was developed to evaluate factors that would influence the PaO 2 / FiO 2 ratio.A significant correlation was observed between the PaO 2 / FiO 2 ratio and intubation period, and length of ICU stay. Univariate predictors of a PaO 2 / FiO 2 ratio < 350 were low body weight, low preoperative PaO 2 , long operation time, high FiO 2 , low postoperative PaO 2 , history of smoking, hypertension and opening of pleura (p < 0.05). Excellent prediction was found with a model consisting of preoperative PaO 2 and hypertension.Conclusion: The results of this study suggest that patients with a low preoperative PaO 2 or hypertension may need more careful peri-and postoperative management since these factors are closely associated with the PaO 2 / FiO 2 ratio. (Jpn Heart J 2001; 42: 143-153)

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Adult respiratory distress syndrome after cardiac surgery

Cited by 130 publications

References 25 publications

Active and Passive Cigarette Smoking and Acute Lung Injury after Severe Blunt Trauma

Active and Passive Cigarette Smoking and Acute Lung Injury after Severe Blunt Trauma

Role of Prostaglandins in Mediating Differences in Human Internal Mammary and Radial Artery Relaxation Elicited by Hypoxia

Predictive Risk Factors for Pulmonary Oxygen Transfer in Patients Undergoing Coronary Artery Bypass Grafting.

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