Preoperative Airway Obstruction as a Cause of Morbidity in Patients Undergoing Mitral Valve Replacement

INTRODUCTION: We aimed to investigate the relationship between preoperative pulmonary function tests detected by obstruction of the airway and postoperative intubation time with prolonged intensive care unit stay in patients undergoing mitral valve replacement. METHODS: Sixtytwo consecutive patients undergoing mitral valve replacement surgery were included. Patients’ gender, presence of systemic disease, smoking history, pulmonary function tests, ejection fraction, pulmonary artery pressure, perioperative cardiopulmonary bypass and aortic clamp time, postoperative intubation time, length of stay in the intensive care unit, preoperative and postoperative laboratory findings, arterial blood gas values were recorded. RESULTS: In 47 patients systemic concomitant diseases were diagnosed. Nine had asthma, 8 had chronic obstructive pulmonary disease. Length of stay in the intensive care unit was significantly lower in patients with respirotary disease under treatment than the patients without respirotary disease (p

Mitral Kapak Replasmanı Yapılan Olgularda Bir Morbidiite Nedeni Olarak Preoperatiif Havayolu Obstrüksiyonu

GİRİŞ ve AMAÇ: Mitral kapak replasmanı hastalarında, preoperatif solunum fonksiyon testleriyle saptanan hava yolu obstruksiyonunun, postoperatif mekanik ventilasyon süresi ve yoğun bakım yatış süresiyle ilişkisini araştırmayı amaçladık. YÖNTEM ve GEREÇLER: Kliniğimizde mitral kapak replasmanı yapılan 62 ardışık hasta, çalışmaya alındı. Cinsiyet, sistemik hastalık varlığı, sigara kullanımı, solunum fonksiyon testleri, ejeksiyon fraksiyonu, pulmoner arter basıncı, peroperatif kardiyopulmoner baypas ve aort klempi süreleri, postoperatif entübasyon süresi, cerrahi yoğun bakım süresi, preoperatif ve postoperatif labratuar testleri, arter kan gazı değerleri kaydedildi. BULGULAR: Hastaların 47’sine eşlik eden sistemik hastalık mevcuttu. Bunlardan 9'u astım, 8'i kronik obstruktif akciğer hastalığı idi. Solunum yolu hastalığı olanlarda yoğun bakım kalış süresi solunum yolu hastalığı olmayanlardan anlamlı olarak daha düşüktü (p

Kaynakça

1. Davarpasand T, Hosseinsabet A, Jalali A. Concomitant coronary artery bypass graft and aortic and mitral valve replacement for rheumatic heart disease: short- and mid-term outcomes. Interact Cardiovasc Thorac Surg 2015; 21:322-8.

2. Najafi M, Sheikhvatan M, Mortazavi SH. Do preoperative pulmonary function indices predict morbidity after coronary artery bypass surgery? Ann Card Anaesth 2015; 18:293-8.

3. Cingoz F, Oz BS, Arslan G, et al. Is chronic obstructive pulmonary disease a risk factor for epistaxis after coronary artery bypass graft surgery? Cardiovasc J Afr 2014; 25:279-81.

4. Smetana GW, Pfeifer KJ, Slawski BA, et al. Risk factors for postoperative pulmonary complications: an update of the literature. Hosp Pract (1995) 2014; 42:126-31.

5. Coffin ST, Waguespack DR, Haglund NA, et al. Kidney dysfunction and left ventricular assist device support: a comprehensive perioperative review. Cardiorenal Med 2015; 5:48-60.

6. Antunes PE, Prieto D, Ferrao de OJ, et al. Renal dysfunction alter myocardial revascularization. Eur Cardiothorac Surg 2004; 25:597-604.

7. Saxena P, Luthra S, Dhaliwal RS, et al. Early changes in pulmonary functions after mitral valve replacement. Ann Thorac Med 2007; 2:111-7.

8. Maddali MM. Chronic obstructive lung disease: Perioperative management. Middle East J Anesthesiol 2008; 19:1219-39.

9. Licker M, Schweizer A, Ellenberger C, et al. Perioperative medical management of patients with COPD. Int J Chron Obstruct Pulmon Dis 2007; 2:493-515.

10. Lindenauer PK, Stefan MS, Shieh MS, et al. Outcomes associated with invasive and noninvasive ventilation among patients hospitalized with exacerbations of chronic obstructive pulmonary disease. JAMA Intern Med 2014; 174:1982-93.

11. Quintana JM, Esteban C, Unzurrunzaga A, et al; IRYSS-COPD group. Predictive score for mortality in patients with COPD exacerbations attending hospital emergency departments. BMC Med 2014; 12:66.

12. Siddiqui UT, Tahir MZ, Shamim MS, et al. Clinical outcome and cost effectiveness of early tracheostomy in isolated severe head injury patients. Surg Neurol Int 2015; 6:65.

13. Tsai WH, Hsu HC, Shih CH. Increased risks of endotracheal tube cuff colonization after prolonged intubation. Chin J Physiol 2014; 57:152- 7.

14. Liu CC, Livingstone D, Dixon E, et al. Early versus late tracheostomy: a systematic review and meta-analysis. Otolaryngol Head Neck Surg 2015; 152:219-27.

15. Whiting D, Yuki K, DiNardo JA. Cardiopulmonary bypass in the pediatric population. Best Pract Res Clin Anaesthesiol 2015; 29:241-56.

16. Roosens C, Heerman J, De Somer F, et al. Effects of off-pump coronary surgery on the mechanics of the respiratory system, lung, and chest wall: Comparison with extracorporeal circulation. Crit Care Med 2002; 30:2430-7.

17. Cislaghi F, Condemi AM, Corona A. Predictors of prolonged mechanical ventilation in a cohort of 3269 CABG patients. Minerva Anestesiol 2007; 73:615-21.

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