title: Clinical Correlation of Early Atelectasis after Bilateral Internal Thoracic Artery Harvest for Coronary Artery Bypass Grafting.
abstract: BACKGROUND
  Atelectasis is a significant complication after cardiac surgery. The current study was designed to assess the significance of atelectasis after bilateral internal thoracic artery (BITA) harvest.
  
  
  METHODS
  The ICU admission chest x-ray of 565 patients undergoing BITA was reviewed. Linear regression modelling was used to assess the relationship between atelectasis and oxygenation as well as patient variables to length of ventilation and length of stay in the Intensive Care Unit (ICU).
  
  
  RESULTS
  Eighty-nine patients (15.8%) had Grade 2/3 atelectasis which was significantly more common on the left as compared to the right (left 0.149 95% CI [0.119-0.178], right 0.027 95% CI [0.013-0.040], p<0.001). Grade 2/3 atelectasis on the right was associated with a significant drop in the pO2 (p=0.001) and the per cent O2-fractional O2 (PF) ratio (p=0.002). Factors associated with increased ventilation time included presence of Grade 2/3 atelectasis (p=0.001) and peripheral vascular disease (PVD) (p<0.001), both of which were predictors of prolonged ICU length of stay (p=0.002 and p<0.001 respectively).
  
  
  CONCLUSIONS
  Early atelectasis is related to impaired oxygenation, prolonged ventilation and prolonged ICU stay. Future research should focus on strategies to minimise atelectasis and to determine if these changes translate into better patient outcomes.
authors.affiliation: Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. Electronic address: cdennie@toh.on.ca.
authors.forename: Carole
authors.initials: C
authors.lastname: Dennie
authors.affiliation: Department of Surgery - Cardiac Surgery Division, University of Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Yen-Yen
authors.initials: YY
authors.lastname: Gee
authors.affiliation: Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Oikonomou
authors.affiliation: Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Thornhill
authors.affiliation: Department of Surgery - Cardiac Surgery Division, University of Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Fraser
authors.initials: F
authors.lastname: Rubens
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D001261:Pulmonary Atelectasis / Q000000981:diagnostic imaging / Q000503:physiopathology; D013895:Thoracic Arteries / Q000601:surgery*
keywords: Anaesthesia; Cardiac-other; Coronary disease; Extracorporeal circulation; Lung-other; Perioperative issues and risk analysis