Lung management during cardiopulmonary bypass: Influence on extravascular lung water

Boldt, Joachim; King, Douglas H.; Scheid, H.; Hempelmann, G.

doi:10.1016/0888-6296(90)90450-t

Cited by 50 publications

(39 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other post-CBP pulmonary dysfunction risk factors are excessive hypervolemia and hemodilution, as stated by Boldt et al (13) These authors concluded that extravascular edema is associated with impaired pulmonary gas exchange in post-CBP posi tive fluid balance patients, more frequent in older than 65 years patients. (6) Systemic inflammatory response syndrome, acute lung injury and acute respiratory distress syndrome in cardiac surgery patients Cardiovascular bypass (CBP) cardiac surgery causes systemic inflammatory response syndrome (SIRS).…”

Section: Cardiac Surgery Postoperative Period Respiratory Failurementioning

confidence: 73%

“…(11) Respiratory pattern changes, muscle incoordination, and reduced pulmonary complacency due to pulmonary and chest wall mechanical properties changes are common during the postoperative period. (12,13) Reduced urinary output-related creatinine level increases were described by Weiss et al (2) as a significant risk factor for hypoxemia between one and 12 hours after cardiac surgery.…”

Section: Cardiac Surgery Postoperative Period Respiratory Failurementioning

confidence: 99%

See 1 more Smart Citation

Lesão pulmonar e ventilação mecânica em cirurgia cardíaca: revisão

Rodrigues¹,

Oliveira²,

Soares³

et al. 2010

Rev. bras. ter. intensiva

View full text Add to dashboard Cite

Section: Cardiac Surgery Postoperative Period Respiratory Failurementioning

confidence: 73%

Section: Cardiac Surgery Postoperative Period Respiratory Failurementioning

confidence: 99%

Lesão pulmonar e ventilação mecânica em cirurgia cardíaca: revisão

Rodrigues¹,

Oliveira²,

Soares³

et al. 2010

Rev. bras. ter. intensiva

View full text Add to dashboard Cite

“…Moreover, the maneuver was associated with a decrease in cardiac output compared to baseline. 14 Boldt et al, 3 on the other hand, reported that EVLW and Q S /Q T increased after bypass regardless of the CPAP pressure, and changes in P a O 2 correlated significantly with changes in EVLW. These investigators showed that static inflation with a moderate level of PEEP (5 cm H 2 O) at an F I O 2 of 0.21 decreased EVLW and improved P a O 2.…”

Section: Discussionmentioning

confidence: 99%

“…The complication of 'postbypass lung' occurs with an incidence from 2%-64% of cardiac surgeries involving CPB, 1,2 and is characterized by an increased alveolar-arterial oxygen partial pressure difference (P (A-a) DO 2 ), atelectasis, and increased extravascular lung water (EVLW). 3,4 Absent or reduced blood flow through the lungs during CPB, surgical trauma, intravascular microaggregates, and leucocyte activation are the main causes of 'postbypass lung'.…”

mentioning

confidence: 99%

Continuous positive airway pressure does not improve lung function after cardiac surgery

Altmay¹,

Karaca²,

Yurtseven³

et al. 2006

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose: Despite the well-documented impairment of pulmonary function after cardiopulmonary bypass, effective precautions and ideal management strategies for this problem are still under debate. This study aimed to evaluate the effects of continuous positive airway pressure (CPAP) applied during cardiopulmonary bypass on respiratory and hemodynamic variables. Methods:In this randomized, prospective, controlled trial, 120 male patients, aged 45 to 70 yr undergoing first-time elective bypass surgery, were randomly assigned to receive either 10 cm H 2 O of CPAP (Group I; n = 60) during cardiopulmonary bypass, or serve as control (Group II; n = 60), where the patient's lungs were vented to atmosphere during the bypass period.Results: Alveolar-arterial oxygen partial pressure difference and shunt fraction were significantly higher in the control group compared with the CPAP group after cardiopulmonary bypass (T 2 ) and after closure of sternum (T 3 ), (P < 0.05). No differences between groups with respect to hemodynamic variables were observed at any time. Postoperative pulmonary function variables were lower in both groups compared to baseline values. Conclusions:Continuous positive airway pressure administered during cardiopulmonary bypass decreased shunt fraction and alveolar-arterial oxygen partial pressure difference during surgery, but had no sustained effect on either variable postoperatively. We conclude that, in patients with normal preoperative pulmonary function, application of 10 cm H 2 O CPAP does not improve lung function after cardiac surgery. Objectif

show abstract

“…An increased alveolar-arterial oxygen partial pressure difference secondary to ventilation-perfusion mismatch, increased interstitial lung water, together with decreased functional residual capacity, have been observed in patients after cardiopulmonary bypass (Boldt et al 1990;Taggart et al 1993). Disturbance of lung mechanics in terms of poor static and dynamic lung compliance also were noted (Kochamba et al 2000;Chaney et al 1998).…”

Section: Introductionmentioning

confidence: 96%

Alveolar Recruitment Strategy During Cardiopulmonary Bypass Does Not Improve Postoperative Gas Exchange and Lung Function

et al. 2009

View full text Add to dashboard Cite

Pulmonary dysfunction with impairment of lung function and oxygenation is one of the most serious problems in the early postoperative period after cardiac surgery. In this study we investigated the effect of alveolar recruitment strategy during cardiopulmonary bypass on postoperative gas exchange and lung function. This prospective randomized study included 32 patients undergoing elective myocardial revascularization with cardiopulmonary bypass. In 16 patients 5 cm H(2)O of positive end-expiratory pressure was applied after intubation and maintained until extubation (Group I). In the other 16 patients (group II) a positive end expiratory pressure (PEEP) of 5 cm H(2)O was maintained as well but was increased to 14 cm H(2)O every 20 min for 2 min during cross clamp. Measurements were taken preoperatively, before skin incision, before and after (3, 24, 48 h) cardiopulmonary bypass and before discharge (6th postoperative day). Postoperative gas exchange, extravascular lung water and lung function showed no significant difference between the groups. Postoperative pulmonary function variables were lower in both groups compared to baseline values. In patients with normal preoperative pulmonary function, application of an alveolar recruitment strategy during cardiopulmonary bypass does not improve postoperative gas exchange and lung function after cardiac surgery.

show abstract

Lung management during cardiopulmonary bypass: Influence on extravascular lung water

Cited by 50 publications

References 22 publications

Lesão pulmonar e ventilação mecânica em cirurgia cardíaca: revisão

Lesão pulmonar e ventilação mecânica em cirurgia cardíaca: revisão

Continuous positive airway pressure does not improve lung function after cardiac surgery

Alveolar Recruitment Strategy During Cardiopulmonary Bypass Does Not Improve Postoperative Gas Exchange and Lung Function

Contact Info

Product

Resources

About