İlhan Sami, Özkan Sevil, Baştopçu Murat, Koçoğulları Cevdet Uğur
Department of Respiratory Medicine, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Research and Training Hospital, İstanbul, Turkey.
Department of Respiratory Medicine, Haydarpaşa Numune Research and Training Hospital, İstanbul, Turkey.
Turk Thorac J. 2020 May;21(3):163-168. doi: 10.5152/TurkThoracJ.2019.180178.
No studies have been specifically conducted on asthma patients undergoing cardiac surgery for assessing mortality and morbidity. Distinct effects of cardiac surgery lead to negative effects on respiratory functions, putting patients with existing lung diseases under an increased risk. We aimed to investigate whether asthma patients are under higher risk for mortality and possible complications after coronary artery bypass graft (CABG) surgery than patients without asthma.
The study included patients who underwent elective CABG surgery at our hospital between November 2014 and November 2015. Patients with a history of asthma were verified with physical examination and spirometric measurements by a single. The asthma group was compared with the controls in terms of mortality and morbidities.
Asthma patients were extubated later than control patients (p=0.028); however, prolonged intubation (longer than 24 h) frequency was not different (p>0.05). Asthma patients required longer stay in the intensive care unit (ICU) (p=0.003) than controls. The incidence of perioperative asthma exacerbations was significantly lower in patients in whom asthma was previously well-controlled. The incidence of postoperative sibilant rhonchi was lower in patients in whom asthma was under control than in those in whom asthma was partially controlled (p=0.020).
Asthma is associated with longer ICU stay and asthma-related pulmonary complications after CABG surgery. Preoperative evaluation of asthma patients scheduled for CABG surgery requires consideration of the control status of asthma. Studies with more controls are needed to provide further evidence on the topic.
尚未专门针对接受心脏手术的哮喘患者进行评估死亡率和发病率的研究。心脏手术的独特影响会对呼吸功能产生负面影响，使现有肺部疾病患者面临更高风险。我们旨在调查与无哮喘患者相比，哮喘患者在冠状动脉旁路移植术（CABG）后是否有更高的死亡风险和可能的并发症。
该研究纳入了2014年11月至2015年11月在我院接受择期CABG手术的患者。有哮喘病史的患者通过单一的体格检查和肺活量测定进行核实。将哮喘组与对照组在死亡率和发病率方面进行比较。
哮喘患者拔管时间比对照组晚（p=0.028）；然而，长时间插管（超过24小时）的频率并无差异（p>0.05）。哮喘患者在重症监护病房（ICU）的停留时间比对照组更长（p=0.003）。既往哮喘控制良好的患者围手术期哮喘发作的发生率显著较低。哮喘得到控制的患者术后哮鸣音的发生率低于哮喘部分得到控制的患者（p=0.020）。
哮喘与CABG术后在ICU的停留时间延长以及与哮喘相关的肺部并发症有关。计划进行CABG手术的哮喘患者术前评估需要考虑哮喘的控制状态。需要更多对照研究以提供关于该主题的进一步证据。
