AUTHOR=Rodriguez-Blanco Yiliam F. , Gologorsky Angela , Salerno Tomas Antonio , Lo Kaming , Gologorsky Edward 

TITLE=Pulmonary Perfusion and Ventilation during Cardiopulmonary Bypass Are Not Associated with Improved Postoperative Outcomes after Cardiac Surgery

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=3

YEAR=2016

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2016.00047

DOI=10.3389/fcvm.2016.00047

ISSN=2297-055X

ABSTRACT=<sec id="ST1"><title>Objectives</title><p>Clinical trials of either pulmonary perfusion or ventilation during cardiopulmonary bypass (CBP) are equivocal. We hypothesized that to achieve significant improvement in outcomes both interventions had to be concurrent.</p></sec><sec id="ST2"><title>Design</title><p>Retrospective case–control study.</p></sec><sec id="ST3"><title>Settings</title><p>Major academic tertiary referral medical center.</p></sec><sec id="ST4"><title>Participants</title><p>Two hundred seventy-four consecutive patients who underwent open heart surgery with CBP 2009–2013.</p></sec><sec id="ST5"><title>Interventions</title><p>The outcomes of 86 patients who received pulmonary perfusion and ventilation during CBP were retrospectively compared to the control group of 188 patients.</p></sec><sec id="ST6"><title>Measurements and main results</title><p>Respiratory complications rates were similar in both groups (33.7 vs. 33.5%), as were the rates of postoperative pneumonia (4.7 vs. 4.3%), pleural effusions (13.9 vs. 12.2%), and re-intubations (9.3 vs. 9.1%). Rates of adverse postoperative cardiac events including ventricular tachycardia (9.3 vs. 8.5%) and atrial fibrillation (33.7 vs. 28.2%) were equivalent in both groups. Incidence of sepsis (8.1 vs. 5.3%), postoperative stroke (2.3 vs. 2.1%), acute kidney injury (2.3 vs. 3.7%), and renal failure (5.8 vs. 3.7%) was likewise comparable. Despite similar transfusion requirements, coagulopathy (12.8 vs. 5.3%, <italic>p</italic> = 0.031) and the need for mediastinal re-exploration (17.4 vs. 9.6%, <italic>p</italic> = 0.0633) were observed more frequently in the pulmonary perfusion and ventilation group, but the difference did not reach the statistical significance. Intensive care unit (ICU) and hospital stays, and the ICU readmission rates (7.0 vs. 8.0%) were similar in both groups.</p></sec><sec id="ST7"><title>Conclusion</title><p>Simultaneous pulmonary perfusion and ventilation during CBP were not associated with improved clinical outcomes.</p></sec>