Clinical Correlation of Early Atelectasis after Bilateral Internal Thoracic Artery Harvest for Coronary Artery Bypass Grafting

BackgroundAtelectasis is a significant complication after cardiac surgery. The current study was designed to assess the significance of atelectasis after bilateral internal thoracic artery (BITA) harvest.MethodsThe ICU admission chest x-ray of 565 patients undergoing BITA was reviewed. Linear regression modelling was used to assess the relationship between atelectasis and oxygenation as well as patient variables to length of ventilation and length of stay in the Intensive Care Unit (ICU).ResultsEighty-nine patients (15.8%) had Grade 2/3 atelectasis which was significantly more common on the left as compared to the right (left 0.149 95% CI [0.119-0.178], right 0.027 95% CI [0.013-0.040], p<0.001). Grade 2/3 atelectasis on the right was associated with a significant drop in the pO2 (p=0.001) and the per cent O2-fractional O2 (PF) ratio (p=0.002). Factors associated with increased ventilation time included presence of Grade 2/3 atelectasis (p=0.001) and peripheral vascular disease (PVD) (p<0.001), both of which were predictors of prolonged ICU length of stay (p=0.002 and p<0.001 respectively).ConclusionsEarly atelectasis is related to impaired oxygenation, prolonged ventilation and prolonged ICU stay. Future research should focus on strategies to minimise atelectasis and to determine if these changes translate into better patient outcomes.