European Journal of Anaesthesiology

Table of Contents - 1998 - Volume 15, Issue 01  


Original Article
(RD) Surgery

Monitoring of respiratory function before and after cardiopulmonary bypass using side-stream spirometry

M. Bund a1c1, W. Seitz a1, K. Uthoff a2, P. Krieg a2, M. Strüber a2 and S. Piepenbrock a1
a1 Department of Anaesthesia, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany
a2 Department of Cardiothoracic Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany

Article author query
bund m   [PubMed][Google Scholar] 
seitz w   [PubMed][Google Scholar] 
uthoff k   [PubMed][Google Scholar] 
krieg p   [PubMed][Google Scholar] 
strüber m   [PubMed][Google Scholar] 
piepenbrock s   [PubMed][Google Scholar] 

Abstract

Pulmonary impairment is more frequent after cardiac surgery than after other major surgical procedures. The present study investigates whether, by using standard respiratory monitoring, i.e. side-stream spirometry and blood gas analysis, it is possible to detect changes in pulmonary function secondary to cardiopulmonary bypass. We investigated 18 patients undergoing elective coronary bypass surgery or aortic valve replacement. Cardiopulmonary bypass resulted in a nonsignificant increase in alveolar-arterial oxygen difference from 33.0 ± 10.6 kPa to 36.1 ± 12.5 kPa and arterial to end-tidal CO2 tension difference from 0.67±0.39 kPa to 0.79±0.54 kPa. Respiratory system resistance was unaltered. In contrast, dynamic compliance decreased significantly after cardiopulmonary bypass from 78.6 ± 22.9 to 65.4 ± 22.4 mL cmH2O−1 with open chest and from 61.0 ± 10.2 to 51.1 ± 17.2 mL cmH2O−1 with closed chest, compared with corresponding values before cardiopulmonary bypass. In conclusion, pulmonary gas exchange was not compromised after cardiopulmonary bypass, but a diminished respiratory compliance was a consistent finding, even in uncomplicated cardiac surgery using routine respiratory monitoring.

(Published Online August 16 2006)
(Accepted May 1997)


Key Words: cardiac surgery; cardiopulmonary bypass; pulmonary function; spirometry.

Correspondence:
c1 Correspondence to: Dr M. Bund.