title: Prevalence and Implications of Abnormal Respiratory Patterns in Cardiac Surgery: A Prospective Cohort Study.
abstract: OBJECTIVE
  To investigate the prevalence and impact of abnormal respiratory patterns in cardiac surgery patients.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Tertiary hospital.
  
  
  METHODS
  Patients scheduled for elective coronary artery bypass graft surgery.
  
  
  METHODS
  None.
  
  
  RESULTS
  Pulmonary function tests were performed in 454 patients before surgery. Abnormal respiratory patterns were defined as follows: obstructive (forced expiratory volume in 1 s [FEV1]/forced vital capacity [FVC]<0.70), restrictive (FEV1/FVC≥0.70 and FVC<80% of predicted), and mixed (FEV1/FVC<0.70 and both FEV1and FVC<80% of predicted). Of the 31 patients with a history of chronic obstructive pulmonary disease, no abnormal respiratory pattern was confirmed in 5. Of the 423 patients without a history of lung disease, the authors newly identified 57 obstructive, 46 restrictive, and 4 mixed patterns. Therefore, lung disease was reclassified in 24.7% of cases. Independent predictors of obstructive pattern were age, male sex, history of smoking, and chronic obstructive pulmonary disease. Obstructive lung disease was associated with 16 hours or longer ventilation. A reduced FEV1was associated with a likelihood of atrial fibrillation (1-L decrement, odds ratio: 1.38, 95% confidence interval: 1.01-to-1.90, p = 0.04) and hospitalization time (regression coefficient: 1.23, 95% confidence interval: 0.54-to-1.91, p<0.001).
  
  
  CONCLUSIONS
  Abnormal respiratory patterns are common and often underdiagnosed in the cardiac surgery setting. Pulmonary function tests help reveal patients at risk of complications and may provide an opportunity for intervention.
authors.affiliation: Department of Anesthesia and Intensive Care, Academician EN Meshalkin Novosibirsk State Budget Research Institute of Circulation Pathology, Novosibirsk, Russia. Electronic address: d_ponomarev@meshalkin.ru.
authors.forename: Dmitry
authors.initials: D
authors.lastname: Ponomarev
authors.affiliation: Department of Physiology, Academician EN Meshalkin Novosibirsk State Budget Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Oksana
authors.initials: O
authors.lastname: Kamenskaya
authors.affiliation: Department of Physiology, Academician EN Meshalkin Novosibirsk State Budget Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Asya
authors.initials: A
authors.lastname: Klinkova
authors.affiliation: Department of Physiology, Academician EN Meshalkin Novosibirsk State Budget Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Irina
authors.initials: I
authors.lastname: Loginova
authors.affiliation: Department of Anesthesia and Intensive Care, Academician EN Meshalkin Novosibirsk State Budget Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Lomivorotov
authors.affiliation: Department of Anesthesia and Intensive Care, Academician EN Meshalkin Novosibirsk State Budget Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Igor
authors.initials: I
authors.lastname: Kornilov
authors.affiliation: Department of Anesthesia and Intensive Care, Academician EN Meshalkin Novosibirsk State Budget Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Shmyrev
authors.affiliation: Department of Cardiac Surgery, Academician EN Meshalkin Novosibirsk State Budget Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Chernavskiy
authors.affiliation: Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Landoni
authors.affiliation: Department of Cardiac Surgery, Academician EN Meshalkin Novosibirsk State Budget Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Karaskov
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods* / Q000639:trends; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000379:methods / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010991:Plethysmography / Q000379:methods* / Q000639:trends; D011300:Preoperative Care / Q000379:methods* / Q000639:trends; D015995:Prevalence; D011446:Prospective Studies; D012120:Respiration Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D012129:Respiratory Function Tests / Q000639:trends
keywords: cardiac surgery; chronic obstructive pulmonary disease; obstructive respiratory pattern; pulmonary function tests; restrictive respiratory pattern