Physiotherapy Section, Department of Physical Rehabilitation and Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Asian Cardiovasc Thorac Ann. 2022 Feb;30(2):156-163. doi: 10.1177/02184923211010079. Epub 2021 Apr 14.
Pulmonary complications after cardiac surgery are very common and lead to an increased incidence of post-operative morbidity and mortality. Several factors, either modifiable or non-modifiable, may contribute to the associated unfavorable consequences related to pulmonary function. This study was aimed to investigate the degree of alteration and factors influencing pulmonary function (forced expiratory volume in one second (FEV) and forced vital capacity), on third, fifth, and seventh post-operative days following cardiac surgery.
This study was executed in 71 patients who underwent on-pump cardiac surgery. Pulmonary function was assessed before surgery and on the third, fifth, and seventh post-operative days. Data including surgical details, information about risk factors, and assessment of pulmonary function were obtained.
The FEV and forced vital capacity were significantly impaired on post-operative days 3, 5, and 7 compared to pre-operative values. The reduction in FEV was 41%, 29%, and 16% and in forced vital capacity was 42%, 29%, and 19% consecutively on post-operative days 3, 5, and 7. Multivariate analysis was done to detect the factors influencing post-operative FEV and forced vital capacity.
This study observed a significant impairment in FEV and forced vital capacity, which did not completely recover by the seventh post-operative day. Different factors affecting post-operative FEV and forced vital capacity were pre-operative FEV, age ≥60, less body surface area, lower pre-operative chest expansion at the axillary level, and having more duration of cardiopulmonary bypass during surgery. Presence of these factors enhances the chance of developing post-operative pulmonary complications.
心脏手术后的肺部并发症非常常见，导致术后发病率和死亡率增加。一些因素，无论是可改变的还是不可改变的，都可能导致与肺功能相关的不良后果。本研究旨在调查心脏手术后第 3、5 和 7 天肺功能（用力呼气量（FEV）和用力肺活量）改变的程度及其影响因素。
本研究纳入 71 例行体外循环心脏手术的患者。在术前和术后第 3、5 和 7 天评估肺功能。收集手术细节、危险因素信息以及肺功能评估等数据。
与术前相比，术后第 3、5 和 7 天 FEV 和用力肺活量明显受损。FEV 分别下降 41%、29%和 16%，用力肺活量分别下降 42%、29%和 19%。术后第 3、5 和 7 天。进行了多变量分析以检测影响术后 FEV 和用力肺活量的因素。
本研究观察到 FEV 和用力肺活量明显受损，且在术后第 7 天仍未完全恢复。影响术后 FEV 和用力肺活量的因素包括术前 FEV、年龄≥60 岁、体表面积较小、腋下线胸部扩张较小、手术中体外循环时间较长。这些因素的存在增加了术后发生肺部并发症的机会。
