Pulmonary dysfunction after cardiac surgery.
Postoperative lung injury is one of the most frequent complications of cardiac surgery that impacts significantly on health-care expenditures and largely has been believed to result from the use of cardiopulmonary bypass (CPB). However, recent comparative studies between conventional and off-pump coronary artery bypass grafting have indicated that CPB itself may not be the major contributor to the development of postoperative pulmonary dysfunction. In our study, we review the associated physiologic, biochemical, and histologic changes, with particular reference to the current understanding of underlying mechanisms. Intraoperative modifications aiming at limiting lung injury are discussed. The potential benefits of maintaining ventilation and pulmonary artery perfusion during CPB warrant further investigation.
Ng
Calvin S H
CS
Division of Cardiothoracic Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
Wan
Song
S
Yim
Anthony P C
AP
Arifi
Ahmed A
AA
D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D001026:Coronary Artery Bypass; D017052:Hospital Mortality; D006801:Humans; D008168:Lung / Q000098:blood supply; D011183:Postoperative Complications / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology*; D015427:Reperfusion Injury / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology*; D012307:Risk Factors; D015996:Survival Rate