Pulmonary function tests do predict outcome after elective cardiac surgery

Durand, M.; Combes, P.; Eisele, John H.; Duret, J.; P, Girardet

doi:10.1016/1053-0770(92)90392-k

“…Alguns estudos prévios com adultos e crianças avaliaram a FP antes 21 , durante ou imediatamente após 24 , ou alguns dias ou meses após as cirurgias 22,26 .…”

Section: Resultsunclassified

“…Vários estudos têm mostrado o potencial das cirurgias cardíacas no prejuízo da FP [19][20][21][22][23] , embora ainda sejam escassos na população pediátrica [24][25][26] . Até o nosso conhe-No primeiro dia após a cirurgia, observou-se queda brusca e significativa do VM, que se manteve, em média, inferior aos valores basais até o terceiro DPO.…”

Section: Discussionunclassified

Pulmonary function assessment in children and teenagers before and after surgical treatment for rheumatic valve disease

Caséca

¹

,

Andrade

²

,

Britto

³

2006

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Objective: To assess pulmonary function in children and adolescents subjected to correction of rheumatic valve disease in order to quantify changes caused by factors inherent to surgery and rheumatic heart disease.Methods: This was a longitudinal and quantitative intervention study, undertaken at a childrens hospital that is a center of excellence for the state of Pernambuco (Instituto Materno Infantil de Pernambuco), between December 2004 and May 2005. Eighteen children suffering from rheumatic fever and indicated for surgery to repair or replace the mitral valve were assessed preoperatively and again on the first and fifth postoperative days. The parameters recorded were minute volume, rapid shallow breathing index, peak expiratory flow, forced vital capacity and inspiratory capacity.Results: All patients were aged 8 to 17 years (mean 12.4±2.1), they had a mean body mass index of 16.1±2.2, and were weaned off invasive mechanical ventilation during the first 10 postoperative hours. All parameters had undergone significant deterioration on the first day (statistically significant, p < 0.01), demonstrating gradual improvement up to the last day of assessment, although, with the exception of minute volume which was no longer significantly different from the fourth day onwards (p > 0.01), without returning to baseline levels. Conclusion:We observed that the pulmonary dysfunction that results from this type of heart surgery is maintained until at least the fifth postoperative day. It appears that this dysfunction is influenced by the pain and mechanical alterations caused by sternotomy and reduced pulmonary compliance post surgery.J Pediatr (Rio J). 2006;82(2):144-50: Rheumatic fever, children, heart surgery, pulmonary function. ResumoObjetivo: Avaliar a função pulmonar de crianças e adolescentes submetidos a correções cirúrgicas de valvulopatias reumáticas, a fim de quantificar as alterações proporcionadas pelos fatores inerentes à cirurgia e à cardiopatia reumática. Resultados: Todos os pacientes tinham entre 8 e 17 anos (idade média de 12,4±2,1), apresentavam um índice de massa corpórea médio de 16,1±2,2 e foram desmamados da ventilação mecânica invasiva nas primeiras 10 horas de pós-operatório. Todos os parâme-tros encontraram-se expressivamente deteriorados no primeiro dia de pós-operatório (estatisticamente significativos com valores de p < 0,01), apresentando gradativas melhoras até o último dia da avaliação, embora sem retornar aos valores basais, exceto o volume minuto, que, a partir do quarto dia de pós-operatório, retornou aos valores pré-operatórios em termos estatísticos (p > 0,01).Conclusão: Observamos que a disfunção pulmonar, proveniente dessa cirurgia cardíaca, se mantém até o quinto dia de pós-operatório e parece ser influenciada pela dor e alteração mecânica provenientes da esternotomia e pela diminuição da complacência pulmonar, ocorridas no pós-operatório. Pulmonary function assessment in children and teenagers before and after surgical treatment for rheumatic valve disease Avaliação da ...

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“…Durand et al, 21 observed a drop of approximately 30% in VC on POD 1, compared with preoperative levels. They also observed that CV increased gradually over the first week and that the reduction in CV was linked with increased respiratory work due to reduced pulmonary compliance, which would then improve as pulmonary mechanics gradually recover.…”

Section: Discussionmentioning

confidence: 99%

“…[24][25][26] To the extent of our knowledge, this is the only study to have monitored the daily progress of PF over the first few postoperative days and compared it to preoperative baseline values. Some previous studies of both adults and children have assessed PF before, 21 during or immediately after, 24 or some days or months after such surgery. 22,26 The results of this study have demonstrated that all PF parameters remained significantly deteriorated until at least 5 days after surgery, with the exception of VE, which had returned to levels comparable with baseline levels from POD 4 onwards.…”

Section: Discussionmentioning

confidence: 99%

“…Several different studies demonstrated the potential of cardiac surgery to compromise PF, [19][20][21][22][23] although such studies are scarce for the pediatric population. [24][25][26] To the extent of our knowledge, this is the only study to have monitored the daily progress of PF over the first few postoperative days and compared it to preoperative baseline values.…”

Section: Discussionmentioning

confidence: 99%

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Avaliação da função pulmonar em crianças e adolescentes no pré e pós-operatório de correção cirúrgica de valvulopatia reumática

Caséca¹,

Andrade²,

Britto

³

2006

J. Pediatr. (Rio J.)

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Objective: To assess pulmonary function in children and adolescents subjected to correction of rheumatic valve disease in order to quantify changes caused by factors inherent to surgery and rheumatic heart disease.Methods: This was a longitudinal and quantitative intervention study, undertaken at a children s hospital that is a center of excellence for the state of Pernambuco (Instituto Materno Infantil de Pernambuco), between December 2004 and May 2005. Eighteen children suffering from rheumatic fever and indicated for surgery to repair or replace the mitral valve were assessed preoperatively and again on the first and fifth postoperative days. The parameters recorded were minute volume, rapid shallow breathing index, peak expiratory flow, forced vital capacity and inspiratory capacity.Results: All patients were aged 8 to 17 years (mean 12.4±2.1), they had a mean body mass index of 16.1±2.2, and were weaned off invasive mechanical ventilation during the first 10 postoperative hours. All parameters had undergone significant deterioration on the first day (statistically significant, p < 0.01), demonstrating gradual improvement up to the last day of assessment, although, with the exception of minute volume which was no longer significantly different from the fourth day onwards (p > 0.01), without returning to baseline levels. Conclusion:We observed that the pulmonary dysfunction that results from this type of heart surgery is maintained until at least the fifth postoperative day. It appears that this dysfunction is influenced by the pain and mechanical alterations caused by sternotomy and reduced pulmonary compliance post surgery.

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Practice Advisory for Preanesthesia Evaluation

2002

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PRACTICE advisories are systematically developed reports that are intended to assist decision-making in areas of patient care where scientific evidence is insufficient to develop an evidence-based model. Practice advisories provide a synthesis of opinion from experts, open forums, and other public sources. Practice advisories report the current state of scientific literature, but are not supported by literature to the same degree as standards or guidelines due to the lack of sufficient numbers of adequately controlled studies.Advisories are not intended as guidelines, standards, or absolute requirements. The use of practice advisories cannot guarantee any specific outcome. They may be adopted, modified, or rejected according to clinical needs and constraints. Practice advisories are subject to periodic revision as warranted by the evolution of medical knowledge, technology, and practice.

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Pulmonary function tests do predict outcome after elective cardiac surgery

Cited by 8 publications

References 3 publications

Pulmonary function assessment in children and teenagers before and after surgical treatment for rheumatic valve disease

Pulmonary function assessment in children and teenagers before and after surgical treatment for rheumatic valve disease

Avaliação da função pulmonar em crianças e adolescentes no pré e pós-operatório de correção cirúrgica de valvulopatia reumática

Practice Advisory for Preanesthesia Evaluation

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