Evaluation of the Effects of Coronary Artery Surgery on Pulmonary Functions by Pulmonary Function Test

Öz

Objective: Chronic obstructive pulmonary disease (COPD) is a frequent comorbid disease in patients undergoing coronary artery bypass grafting (CABG) surgery, with an incidence ranging from 4% to 20.5%. Conventionally, COPD was recognized as a surgical contraindication to CABG. Because of the recent improvements in surgical techniques, anesthesia, and postoperative management, CABG has been performed more commonly in patients with COPD. However, studies have shown the various effects of COPD on postoperative morbidity and mortality after CABG. In our study, we aimed to investigate the effect of CABG surgery on respiratory functions with the respiratory function test performed in the preoperative and postoperative periods. Material and Methods: Fifty patients who underwent isolated CABG surgery in our clinic were included in the study. 24 Patients with preoperative FEV1 value <%70 were taken into COPD group (Group 1) and the remaining 26 patients were taken into control group (Group 2) according to the respiratory function tests. Results: In COPD group mechanical ventilation time (Group 1: 16.5 ± 2.6 hours, Grup 2: 14.9 ± 2.7 hours; p=0.0001) and hospital stay (Group 1: 13.8 ± 5.4 days, Group 2: 10.1 ± 2.5 days; p=0.004) were significantly increased compared to the control group. Pulmonary function parameters were not significantly changed in COPD group but on the other hand significant decrease in postoperative values was seen in the control group. Conclusion: The diagnosis, evaluation and start of appropriate treatment of COPD in preoperative period are significantly important factors in order to reduce of respiratory complications during postoperative period in CABG patients. For this reason preoperative respiratory function tests should be applied routinely in CABG patients.

Anahtar Kelimeler

• Chronic Obstructive Pulmonary Disease
• Coronary Artery Bypass Greft Surgery
• Respiratory Function Tests.

Koroner Arter Cerrahisinin Solunum Fonksiyonlarına Etkilerinin Solunum Fonksiyon Testi İle Değerlendirilmesi

Öz

Giriş ve Amaç: Kronik Obstrüktif Akciğer Hastalığı (KOAH), koroner arter bypass greft operasyonu (CABG) yapılan hastalarda sık bir komorbid hastalıktır ve insidansı %4 ile %20,5 aralığındadır. KOAH geleneksel olarak CABG için cerrahi kontraendikasyon olarak bilinir. Cerrahi teknik, anestezi ve postoperatif hasta yönetimindeki son gelişmelerden dolayı CABG artık KOAH’lı hastalarda çok yaygın bir şekilde yapılmaktadır. Ancak son çalışmalar, CABG sonrası postoperatif mortalite ve morbidite üzerine KOAH’ın çeşitli etkilerini göstermiştir. Çalışmamızda CABG ameliyatının solunum fonksiyonlarına etkisini preoperatif ve postoperatif dönemde yapılan solunum fonksiyon testi ile araştırmayı amaçladık. Gereç ve Yöntemler: Kliniğimizde izole CABG cerrahisi uygulanan 50 hasta çalışmaya dahil edildi. Preoperatif solunum fonksiyon testinde FEV1 değeri <%70 olan toplam 24 hasta KOAH grubunu (Grup 1), geri kalan 26 hasta ise kontrol grubunu (Grup 2) oluşturdu. Bulgular: KOAH grubunda mekanik ventilasyonda kalış süresi (Grup 1’de 16.5 ± 2.6 saat, Grup 2’de 14.9 ± 2.7 saat; p=0.0001) ve hastanede yatış süreleri (Grup 1’de 13.8 ± 5.4 gün, Grup 2’de 10.1 ± 2.5 gün; p=0.004) bakımından kontrol grubuna göre anlamlı olarak uzamış idi. Solunum fonksiyon test parametrelerine bakıldığında KOAH grubunda zaten düşük olan değerlerde anlamlı bir düşme gözlenmezken, Kontrol grubunda postoperatif değerlerde preoperatif değerlere göre anlamlı bir düşme gözlenmiştir. Sonuç: CABG ameliyatı geçirecek hastalara preoperatif dönemde KOAH tanısının konması ve şiddetinin belirlenmesi; preoperatif dönemde gerekli tedavinin başlanması, intraoperatif ve postoperatif dönemde gelişebilecek komplikasyonları azaltmak ve/veya önlemek, takip edilecek stratejiler ve alınacak önlemler açısından önemlidir. Bu nedenle CABG ameliyatı olacak her hastaya preoperatif dönemde solunum fonksiyon testi rutin olarak uygulanmalıdır

Anahtar Kelimeler

• Kronik Obstrüktif Akciğer Hastalığı
• Koroner Arter Hastalığı
• Solunum fonksiyon testi

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