Effects of pleural opening on respiratory function tests in cardiac surgery: a prospective study.
OBJECTIVE
To show the effects on lung function of the opening pleura in patients undergoing cardiac surgery.


METHODS
66 patients were included. Patients were allocated into two groups. In group 1 (n=21) pleura was intact, in group 2 (n=45) pleura was opened. Both groups were compared prospectively in terms of preoperative and on the post-operative 5th day pulmonary function tests (PFT), preoperative, postoperative first and fifth day arterial blood gas analysis, preoperative and postoperative first day mixt venous oxygen saturation, bleeding, operation periods, pulmonary complications, intensive care and hospital stay period and mortality.


RESULTS
There was significant decrease in all PFT indicators on 5th post-operative day in group 2 (p < 0.01). Although there was a significant decrease in FEV1 on 5th post-operative day in group 1 (p < 0.001), other pulmonary functions parameters were not change significantly (p > 0.025). In group 2 much more decline in pulmonary function test parameters than group 1 were observed (p < 0.05). There was not statistically significant difference in blood gas analysis and mixed venous oxygen saturation values in group 1 (p > 0.05). But in group 2 except pH and PaCO2, other blood gas measurements were significantly decreased on the postoperative first and fifth day (p < 0.008). In group 2 except pH and PCO2, other parameters were less than the other Group (p < 0.01). The drained amount was still significantly higher in group 2 (p < 0.001). The frequency of the revision due to bleeding was observed much more in group 2.


CONCLUSIONS
Protection of the integrity of pleura may have positive effects on pulmonary functions in cardiac surgery.
Department of Cardiovascular Surgery, Ankara Education and Research Hospital, Ankara, Turkey. yener@comu.edu.tr.
A
A
Uzun
A Ü
AÜ
Yener
S
S
Kocabeyoglu
Ö F
ÖF
Ciçek
E
E
Yasar
Ö
Ö
Yener
A
A
Yalçinkaya
M C
MC
Çiçek
S
S
Turan
M M
MM
Ulas
D000328:Adult; D000368:Aged; D001784:Blood Gas Analysis; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007362:Intensive Care Units; D007902:Length of Stay; D008171:Lung Diseases / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010994:Pleura / Q000378:metabolism*; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012129:Respiratory Function Tests
D010100:Oxygen