Comparison of Pulmonary Gas Exchange in OPCAB Versus Conventional CABG

Syed, Akbar; Fawzy, Hosam; Farag, Atef; Nemlander, Arto

doi:10.1016/j.hlc.2004.03.015

Cited by 19 publications

(9 citation statements)

References 21 publications

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“…Our data do not suggest any amelioration of lung vascular injury and atelectasis by off-pump as compared to on-pump surgery, and similar degree of pulmonary dysfunction and duration of mechanical ventilation in the ICU, as observed before, even though mechanisms in these studies were not addressed [8,20-23,25-29]. In other observational studies and randomized trials [2,11,17-21,30,31], however, authors found off-pump versus on-pump coronary artery surgery to be associated with less pulmonary complications, less oxygenation impairment, earlier extubation, shorter mechanical ventilation and less often pneumonia, but these observations also remained largely unexplained.…”

Section: Discussionmentioning

confidence: 49%

Mechanisms of pulmonary dysfunction after on-pump and off-pump cardiac surgery: a prospective cohort study

Groeneveld

Jansen

Verheij

2007

J Cardiothorac Surg

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Section: Discussionmentioning

confidence: 49%

Mechanisms of pulmonary dysfunction after on-pump and off-pump cardiac surgery: a prospective cohort study

Groeneveld

Jansen

Verheij

2007

J Cardiothorac Surg

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“…Causative mechanisms include ischaemia-reperfusion, endothelial dysfunction, systemic inflammation and atelectasis (Dodd-o et al, 2004; Syed et al, 2004; Fan et al, 2006). Analysis of intra-operative lung specimens showed evidence of alveolar oedema, extravasation of erythrocytes and neutrophils, and congested alveolar capillaries (Wasowicz et al, 1999).…”

Section: Human Models Of Alimentioning

confidence: 99%

Human models of acute lung injury

Proudfoot

McAuley

Griffiths

et al. 2011

Disease Models &Amp; Mechanisms

101

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Acute lung injury (ALI) is a syndrome that is characterised by acute inflammation and tissue injury that affects normal gas exchange in the lungs. Hallmarks of ALI include dysfunction of the alveolar-capillary membrane resulting in increased vascular permeability, an influx of inflammatory cells into the lung and a local pro-coagulant state. Patients with ALI present with severe hypoxaemia and radiological evidence of bilateral pulmonary oedema. The syndrome has a mortality rate of approximately 35% and usually requires invasive mechanical ventilation. ALI can follow direct pulmonary insults, such as pneumonia, or occur indirectly as a result of blood-borne insults, commonly severe bacterial sepsis. Although animal models of ALI have been developed, none of them fully recapitulate the human disease. The differences between the human syndrome and the phenotype observed in animal models might, in part, explain why interventions that are successful in models have failed to translate into novel therapies. Improved animal models and the development of human in vivo and ex vivo models are therefore required. In this article, we consider the clinical features of ALI, discuss the limitations of current animal models and highlight how emerging human models of ALI might help to answer outstanding questions about this syndrome.

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“…Off pump coronary artery bypass (OPCAB) surgery seems to provide better lung protection by eliminating ischemia-reperfusion injury through maintaining lung ventilation and avoiding CPB. Many studies consistently reported better early and midterm outcomes in OPCAB when compared with conventional on-pump CABG: fewer respiratory complications, shorter intubation time and ITU stay, reduced incidence of pneumonia, and overall shorter hospital stay [ 90 – 92 ].…”

Section: Pulmonary Protection Strategiesmentioning

confidence: 99%

Pulmonary Protection Strategies in Cardiac Surgery: Are We Making Any Progress?

Jaaly

Zakkar

Fiorentino

et al. 2015

Oxidative Medicine and Cellular Longevity

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Pulmonary dysfunction is a common complication of cardiac surgery. The mechanisms involved in the development of pulmonary dysfunction are multifactorial and can be related to the activation of inflammatory and oxidative stress pathways. Clinical manifestation varies from mild atelectasis to severe respiratory failure. Managing pulmonary dysfunction postcardiac surgery is a multistep process that starts before surgery and continues during both the operative and postoperative phases. Different pulmonary protection strategies have evolved over the years; however, the wide acceptance and clinical application of such techniques remain hindered by the poor level of evidence or the sample size of the studies. A better understanding of available modalities and/or combinations can result in the development of customised strategies for the different cohorts of patients with the potential to hence maximise patients and institutes benefits.

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Comparison of Pulmonary Gas Exchange in OPCAB Versus Conventional CABG

Cited by 19 publications

References 21 publications

Mechanisms of pulmonary dysfunction after on-pump and off-pump cardiac surgery: a prospective cohort study

Mechanisms of pulmonary dysfunction after on-pump and off-pump cardiac surgery: a prospective cohort study

Human models of acute lung injury

Pulmonary Protection Strategies in Cardiac Surgery: Are We Making Any Progress?

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