[Immediate postoperative respiratory complications after coronary surgery].
The influence of anesthesia, surgical procedure and special conditions of open-heart surgery upon respiratory function alterations is analyzed. Hypoxemia (present even in non-complicated open heart surgery) can be due to alveolar hypoventilation, ventilation-perfusion mismatch or shunt. The origin of atelectasias (present in 50-92% of patients) and pleural effusion (42-87%) is discussed. Phrenic nerve damage is usually secondary to thermal injury. Other less common complications are discussed. The influence of age, smoking and previous pulmonary diseases on respiratory complications is analyzed. Respiratory care after heart surgery (as time and requisites of extubations) and results of different methods (CPAP, PEEP, incentive inspirometry) are reviewed.
Instituto de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina.
S A
SA
Quadrelli
G
G
Montiel
A J
AJ
Roncoroni
A
A
Raimondi
D003327:Coronary Disease / Q000601:surgery*; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D010791:Phrenic Nerve / Q000473:pathology; D010996:Pleural Effusion / Q000209:etiology; D011183:Postoperative Complications; D001261:Pulmonary Atelectasis / Q000209:etiology; D012140:Respiratory Tract Diseases / Q000209:etiology*