Pleural opening impairs respiratory system compliance and resistance in off-pump coronary artery bypass grafting.
OBJECTIVE
This study evaluated the effect of pleurotomy on respiratory system compliance and resistance in off-pump coronary artery bypass (OPCAB) using the left internal thoracic artery (LITA).


METHODS
Thirty-two patients were prospectively allocated into two groups: OP group (n = 16 patients with open left pleural cavity); IP group (N.=16 patients with intact pleural cavity). Static and dynamic lung compliance and total respiratory system resistance calculation were recorded at anesthesia induction (before chest opening) and immediately after chest closure.


RESULTS
Static lung compliance values significantly decreased after chest closure in both groups (P < 0.0001), but the OP group had a significantly greater decline (P = 0.0007). Dynamic lung compliance decreased in either groups after chest closure (P < 0.0001), however, no significant difference was found between groups (P = 0.228). Total respiratory system resistance increased in both groups (P < 0.05), however the OP group had a higher increase (P = 0.0005). Orotracheal intubation time (P = 0.041) and hospital stay (P = 0.0004) were higher in the OP group.


CONCLUSIONS
Pleura opening and need of chest tube insertion induced significant reduction in static lung compliance and increase in total respiratory system resistance, furthermore contributing to impair pulmonary dysfunction in the early postoperative period after OPCAB.
Cardiovascular Surgery Discipline, Federal University of São Paulo, San Paolo, Brazil. kellytavolaro@bol.com.br
K C
KC
Tavolaro
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Guizilini
D W
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Bolzan
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RB
Dauar
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Buffolo
J E
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Succi
W J
WJ
Gomes
D000328:Adult; D000368:Aged; D000403:Airway Resistance; D001938:Brazil; D016009:Chi-Square Distribution; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D007902:Length of Stay; D008170:Lung Compliance; D008171:Lung Diseases / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000601:surgery*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome