Immediate pulmonary dysfunction in ischemic heart disease patients undergoing off-pump versus on-pump CABG

BackgroundMany studies have shown important changes in lung function tests after coronary artery surgeries. It is controversial if off-pump surgery can give a better and shorter recovery than the on-pump. The aim of this work was to study immediate early pulmonary dysfunction in ischemic heart disease patients undergoing off-pump versus on-pump coronary artery bypass grafting (CABG) in order to evaluate pulmonary dysfunction caused by cardio-pulmonary bypass (CPB) in patients undergoing on-pump CABG.Patients and methodA prospective randomized study was carried out on 40 patients submitted to coronary artery surgery at Kasr El-Aini University Hospital, Cairo, Egypt. They were randomly divided into two groups; group A: 20 patients undergoing CABG using heart-lung machine (on-pump), and group B: 20 patients undergoing off-pump CABG. All patients had: spirometric evaluation, 6 min walk test pre-operatively and at the post-operative fifth day. Measurement of arterial blood gases (ABGs) and calculation of P/F ratio was recorded pre-operative, post-induction and post CABG. Post-operative intensive care unit (ICU) events were also assessed.ResultsPost-operative spirometric data and 6 min walk distance decreased in both groups, when compared to pre-operative values, with significant differences between the two groups. No significant reduction in arterial oxygen pressure (PaO2), carbon dioxide pressure (PaCO2) and P/F Ratio occurred post-operatively.ConclusionPulmonary functions deteriorate significantly after coronary artery revascularization with and without CPB, but to a significant greater reduction among those on-pump than among those off-pump surgeries.