Early postperfusion assessment of gas exchange and postoperative extubation outcome following coronary artery surgery
Piotr Knapik, James B. Richardson, Ian McLellan
Med Sci Monit 1998; 4(4): CR684-687
Available online: 1998-07-01
Background:Patients for elective coronary artery bypass grafting (CABG) with good preoperative lung function are foreseen as candidates for early extubation. However, individual reaction of the patient's lung and impairment of gas exchange caused by extracorporeal perfusion is another important and unpredictable factor.
Material/Methods:100 patients with normal lung function who underwent uncomplicated CABG were studied postoperatively and retrospectively to find out whether first postoperative arterial oxygen tension on 100% oxygen may indicate the duration of required respiratory support. All patients were extubated on the basis of conventional criteria.
Results: Correlation of oxygen tension to the time of ventilation was found to be significant. Comparison of the duration of postoperative ventilatory support for different ranges of oxygen tension resulted in significant differences between ranges with a narrow standard deviation for the group with high postoperative oxygen tension.
Conclusions: We concluded that the first postperfusion oxygen tension may be recognized as a simple and reasonably reliable predicting factor for the period of postoperative ventilation, especially if it exceeds 30 kPa in patients following uncomplicated CABG.
Keywords: extubation, cardiac surgery, oxygen tension