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Respiratory changes after open-heart surgery

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Abstract

Breathing pattern was studied non-invasively in 20 coronary artery bypass surgery patients before the operation and post-operatively after weaning from mechanical ventilation. Post-operatively minute ventilation (VE), breathing frequency (Fr) and mean inspiratory flow (VT/TI) increased (28%, 42%, 27%;p<0.01,p<0.001,p<0.01, respectively), while tidal volume (VT) decreased (15%,p<0.025). CO2 production (VCO2) and oxygen consumption (VO2) increased postoperatively (p<0.001 for both), contributing to the increase in ventilatory demand. Reduced variation of VT and Fr (p<0.001,p<0.01, respectively) and number of sighs (p<0.001) were characteristic of the post-operative breathing pattern. Post-operatively an increase in the contribution of rib cage (%RC) to tidal volume in the supine position was observed suggesting reduced motion of the diaphragm. All patients had atelectasis, 17 had pleural fluid and only 6 normal vascularity post-operatively. The shallow breathing in combination with increased ventilatory demand, impaired gas exchange and the surgical trauma of the thorax predispose to postoperative respiratory complications.

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Tulla, H., Takala, J., Alhava, E. et al. Respiratory changes after open-heart surgery. Intensive Care Med 17, 365–369 (1991). https://doi.org/10.1007/BF01716198

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