[Incidence of pulmonary complications in myocardial revascularization].
BACKGROUND
despite the increasingly careful attempts to reduce perioperative risks, pulmonary complications following surgery are still very common, leading to longer length of hospital stays or death.


OBJECTIVE
to describe the incidence of pulmonary complications and identify their association with duration of extracorporeal circulation (ECC), surgery and ischemia, number of bypass grafts performed, location of drains and length of drainage following myocardial revascularization (MRV).


METHODS
this contemporaneous cohort consisted of 202 patients undergoing elective myocardial revascularization (MRV) with saphenous vein graft and internal mammary artery graft and ECC, at a referral university cardiology hospital in Southern Brazil, from April 2006 to November 2007. The following outcomes were analyzed: duration of mechanical ventilation; pneumonia onset; atelectasis; pleural effusion; location of drains and time of removal; and length of hospital stay.


RESULTS
of the 202 patients, 90 developed some sort of pulmonary complication. The incidence of pleural effusion was 84%, whereas atelectasis was 65%. The following variables were associated with pulmonary complications: duration of ECC (p = 0.003), surgery (p = 0.040) and ischemia (p = 0.001); length of drainage (p = 0.050) and location of pleural drains (p = 0.033); age (p = 0.001); ejection fraction (p = 0.010); diagnosis of asthma (p = 0.047) and preoperative abnormal chest X-ray findings (p = 0.029).


CONCLUSIONS
variables related to the complexity of the surgery and preexisting comorbidities are associated with a high incidence of postoperative pulmonary complications. These data reinforce the importance of having patients undergo perioperative clinical assessment to detect early respiratory complications after MRV.
Ortiz
Leila D N
LD
Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia. ldonrtiz@ibest.com.br
Schaan
Camila W
CW
Leguisamo
Camila P
CP
Tremarin
Katiane
K
Mattos
Waldo L L D
WL
Kalil
Renato A K
RA
Pellanda
Lucia C
LC
D001938:Brazil / Q000453:epidemiology; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation; D005112:Extracorporeal Circulation / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000009:adverse effects*; D012121:Respiration, Artificial / Q000009:adverse effects / Q000295:instrumentation; D012140:Respiratory Tract Diseases / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D013997:Time Factors