Effect of Pulmonary Function Tests on Mortality and Morbidity Associated with Open Heart Surgery Performed with Cardiopulmonary Bypass
Keywords: Cardiopulmonary bypass, respiratory function test, spirometry, chronic obstructive pulmonary disease, coronary artery bypass surgery, open heart surgery
Introduction: We aimed to evaluate the relationship of mortality and morbidity associated with normal and low pulmonary function test results of patients undergoing open cardiac surgery. Patients and Methods: Sixty patients who underwent open cardiac surgery between May 2018 and September 2018 were included in the study. Patients were divided into two groups: Group 1 (n= 30) included patients with low pulmonary function test results and Group 2 (n= 30) included patients with normal pulmonary function test results. Cardiopulmonary bypass (CPB) was used in all patients who underwent open cardiac surgery. Patients who underwent emergency surgery and who could not undergo respiratory function tests for contraindicated reasons were excluded from the study. Surgical procedures were same in both the groups. Comparison was made using preoperative demographic data, intraoperative surgical data, postoperative hemodynamic data, intubation process data, inotropic support use and duration, complication status, intensive care unit and day care unit stays, and mortality. Results: Mortality rate was similar in both the groups (p= 1.000). Extubation time and inotropic support time was longer in Group 1 than in Group 2 but was not statistically significant (p= 0.170). However, respiratory complications were more common in Group 1 [n= 10 (33.33%) in Group 1; n= 6 (20%) in Group 2; p value= 0.125]. Non-invasive ventilation requirement using continuous positive airway pressure was more common in Group 1 than in Group 2 (p= 0.043). Life-threatening supraventricular arrhythmia and new-onset atrial fibrillation was more common in Group 1 than in Group 2 (p= 0.049). Conclusion: Early period mortality is not affected so much in the patients with low pulmonary function test results who are undergoing open heart surgery with CPB. Nevertheless respiratory complications and life threatening arrhythmias are more common in this group of patients. Preoperative, detailed examination and respiratory interventions are necessary and useful to reduce the risk of operation.