Infant thoracic surgery: procedure-dependent pulmonary response.
Respiratory insufficiency is a common complication of thoracic surgery in infants. To better define this dysfunction, pulmonary compliance (CL) and resistance (R) were measured for 17 infants who underwent common thoracic procedures: Blalock-Taussing shunting (n = 7) repair of congenital coarctation of the aorta (n = 10). Measurements were obtained preoperatively and 0, 1, and 3 days postoperatively. Preoperatively, CL was lower and R was similar for the two groups. Both groups had decreased CL and increased R on postoperative day 0; infants with coarctation had recovery to preoperative values by postoperative day 1 for CL, and day 3 for R. CL and R did not return to the preoperative values by postoperative day 3 in infants with a shunt procedure. The changes in R were greater than those in CL for both groups in the postoperative period. These data indicate that such thoracic procedures are associated with pulmonary morbidity that is airway-predominant, and that the degree of compromise and the time until recovery are, in part, procedure-specific.
Greenspan
J S
JS
Department of Pediatrics, Thomas Jefferson Medical College, Philadelphia, PA, USA.
Davis
D A
DA
Russo
P
P
Speziali
G
G
Antunes
M J
MJ
Spitzer
A R
AR
Shaffer
T H
TH
D000403:Airway Resistance / Q000502:physiology; D000714:Anastomosis, Surgical; D001017:Aortic Coarctation / Q000601:surgery; D001807:Blood Vessel Prosthesis; D004374:Ductus Arteriosus, Patent / Q000601:surgery; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000503:physiopathology*; D008170:Lung Compliance / Q000502:physiology; D011175:Positive-Pressure Respiration / Q000379:methods; D011651:Pulmonary Artery / Q000601:surgery; D012119:Respiration; D012131:Respiratory Insufficiency / Q000209:etiology*; D013348:Subclavian Artery / Q000601:surgery; D015300:Ventilator Weaning