CARDIOVASCULAR
ENGINEERING
Journal for Extracorporeal Circulation, Assist Devices,Transplantation and Artificial Organs
|
|
CARDIOVASCULAR
|
Volume 3, 1998, No 1 |
Abstract:
Background: There are conflicting results with regard to the
impact of COPD history on early postoperative course in patients
undergoing open heart surgery. Methods: We studied 867 patients
who underwent consecutively CABG surgery, during a three-year
period (1994-1997) in order to find the prevalence and the
prognostic importance of COPD history on the postoperative course
in patients undergoing CABG surgery. COPD patients were treated
preoperatively with bronchodilators when indicated, until
bronchospasm was under control. Results: History of COPD was
found in 101 patients (11.6 %). They were 93 males (92.1%) and 8
females, of mean (± S.D.) age 58.8 (± 6.1) years. Severe,
moderate and mild COPD was found in 18 (17.8%), 34 (33.7%), and
49 (48.5%) patients, respectively. COPD group included 72
(71.3%), patients with chronic bronchitis, 25 with predominant
pulmonary emphysema, and 4 patients with unremitting bronchial
asthma. Bronchodilators were received by 62 COPD patients before
surgery. Respiratory complications developed in 24 COPD patients
(23.7 %) and 122 patients (15.9 %) in the control group (P=0.06).
Prolonged mechanical ventilatory support (> 1 d.) was needed
by 7 COPD patients (6.9 %) and 46 patients (6 %) in the control
group (P=0.8). Nosocomial infection developed in 5 COPD (4.9 %)
and in 32 patients (4.2 %) of the control group (P=0.9). Mean ICU
and hospital stays were 2.0 ± 1.1 and 8.1 ± 1.2 days,
respectively in COPD group, and 1.8 ± 0.9 (P=0.04), and 7.9 ±
1.4 in control group (P=0.1). Total hospitalization costs were
similar in both groups (P=0.4). Mortality rate was found to be l%
in COPD patients and 0.9 % in control group (P=0.7). Conclusions:
There was no statistically significant difference in morbidity
and mortality rates between COPD patients and controi group after
CABG surgery (P <0.05). preoperative pulmonary evaluation and appropriate pulmonary medication seems to be very essential for successful management on these patients.
Keywords:
coronary artery bypass surgery, chronic obstructive pulmonary
disease (COPD), morbidity, mortality, outcome
Address for Correspondence:
Reference:
(CVE. 1998; 3 (1): 26-31)
[Pabst Science Publishers] [CVE Homepage] [Contents] [Editorials] [Masthead] [Search] [Orders]
PABST SCIENCE PUBLISHERS
Lengerich, Berlin, Düsseldorf,
Leipzig, Riga, Scottsdale AZ (USA),
Wien, Zagreb