Key result
Pleurotomy during CPB is linked to increased airway resistance and impaired pulmonary function versus intact pleurae.
Why the study?
Does pleurotomy affect pulmonary function in adults and children undergoing anesthesia?
Observational
Does pleurotomy affect pulmonary function in adults and children undergoing anesthesia?
Pleurotomy, rather than cardiopulmonary bypass itself, is the primary cause of impaired pulmonary function during cardiac surgery, which can be mitigated by humidification and intermittent deep breaths.
In adults and children, we measured airway resistance, compliance, alveolar-arterial oxygen gradient (100% oxygen), and dead space:tidal volume ratio early and late in anesthesia. Operations performed included cardiac bypass, and thoracic, abdominal, and surface procedures. Airway resistance increased when the pleura was opened. However, with intact pleurae even cardiopulmonary bypass had no effect on pulmonary performance. The deleterious effects of pleurotomy were alleviated by humidification of the inspired-gas mixture, and, during cardiopulmonary bypass, by providing intermittent deep breaths. We concluded that pleurotomy impairs pulmonary function primarily through retraction of the lungs and through retainment of secretions.
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J. Ghia (1970) conducted an observational in Anesthesia for various surgical procedures. Pleurotomy and cardiopulmonary bypass vs. Intact pleurae was evaluated on Airway resistance, compliance, alveolar-arterial oxygen gradient, and dead space:tidal volume ratio. Pleurotomy increased airway resistance and impaired pulmonary function, whereas cardiopulmonary bypass with intact pleurae had no effect on pulmonary performance.
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