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心脏手术患者的肺功能测定评估及其与术后肺部并发症的相关性

Spirometry Assessment and Correlation With Postoperative Pulmonary Complications in Cardiac Surgery Patients.

作者信息

Alam Masood, Shehzad Muhammad Imran, Hussain Shafqat, Paras Iftikhar, Kanwal Masooma, Mushtaq Azam

机构信息

Pulmonology, Chaudhary Pervaiz Elahi Institute of Cardiology, Multan, PAK.

Cardiac Surgery, Chaudhary Pervaiz Elahi Institute of Cardiology, Multan, PAK.

出版信息

Cureus. 2020 Oct 23;12(10):e11105. doi: 10.7759/cureus.11105.

Abstract

Objective To observe spirometry and its correlation with postoperative pulmonary complications in cardiac surgery patients. Study design Prospective observational study Place and duration of the study Chaudhary Pervaiz Elahi Institute of Cardiology (CPEIC) Multan, from January 1, 2017, to June 30, 2020 Methodology Written informed consent was taken from 357 patients. Spirometry was performed in all the patients using the conventional method. Baseline data, including gender, age, body mass index (BMI), living area, smoking history, known lung illness, six-minute walk distance, predicted forced vital capacity (FVC) %, predicted forced expiratory volume in one second (FEV1) %, and type of the procedure such as aortic valve replacement (AVR), coronary artery bypass grafting (CABG), double-valve replacement (DVR), and mitral valve replacement (MVR) were documented for all the patients. Outcome data included postoperative ICU length of stay (LOS), respiratory failure, respiratory infection, atelectasis, and mortality. Results The most common procedure was CABG and MVR proceeded by n=254 (71.1%) and n=83 (23.2%) patients, respectively. Postoperative complications, such as respiratory failure, respiratory infection, and atelectasis, was noted in n=29 (8.1%), n=28 (7.8 %), and n=127 (35.6 %) patients, respectively, while n=5 (1.4%) patients died. Conclusion Deranged pulmonary function tests (PFTs) are associated with poor prognosis following elective cardiac surgery in terms of postoperative pulmonary complications such as pulmonary infection, respiratory failure, and atelectasis. There is a significant difference in percentage predicted of FVC and FEV1 in patients who developed atelectasis and respiratory tract infection.

摘要

目的 观察心脏手术患者的肺功能测定及其与术后肺部并发症的相关性。研究设计 前瞻性观察性研究 研究地点和时间 木尔坦的乔杜里·佩尔瓦伊兹·埃拉希心脏病研究所(CPEIC),2017年1月1日至2020年6月30日 方法 对357例患者获取了书面知情同意书。所有患者均采用传统方法进行肺功能测定。记录了所有患者的基线数据,包括性别、年龄、体重指数(BMI)、居住地区、吸烟史、已知肺部疾病、6分钟步行距离、预计用力肺活量(FVC)%、预计第1秒用力呼气量(FEV1)%以及手术类型,如主动脉瓣置换术(AVR)、冠状动脉旁路移植术(CABG)、双瓣置换术(DVR)和二尖瓣置换术(MVR)。结果数据包括术后重症监护病房住院时间(LOS)、呼吸衰竭、呼吸道感染、肺不张和死亡率。结果 最常见的手术是CABG和MVR,分别有n = 254例(71.1%)和n = 83例(23.2%)患者进行。分别有n = 29例(8.1%)、n = 28例(7.8%)和n = 127例(35.6%)患者出现术后并发症,如呼吸衰竭、呼吸道感染和肺不张,而有n = 5例(1.4%)患者死亡。结论 紊乱的肺功能测试(PFTs)与择期心脏手术后肺部感染、呼吸衰竭和肺不张等术后肺部并发症的不良预后相关。发生肺不张和呼吸道感染的患者在FVC和FEV1的预计百分比方面存在显著差异。

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