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Article description

Summary:

• This review examines the available information on the incidences, consequences, and treatments of postoperative pulmonary complications (PPCs) after cardiac surgery.
• Respiratory complications remain a leading cause of postcardiac surgical morbidity and can prolong hospital stays and increase costs.
• This study is an international multicenter prospective study (42 international centers in 9 countries). The study included 707 adult patients who underwent cardiac surgery under cardiopulmonary bypass.
• The authors defined the PPCs as the occurrence of at least one pulmonary complication among the following: atelectasis, pleural effusion, respiratory failure, respiratory infection, pneumothorax, bronchospasm, or aspiration pneumonitis.
• The study had a follow up for a couple of weeks
• Three hundred seventy-three patients had PPCs (55%); in 190 patients (64%), the lungs were not ventilated during the cardiopulmonary bypass.
• Implementation of a ventilation strategy could decrease PPCs. Recruitment maneuvers with low tidal volumes and a high PEEP should be considered in an open-lung approach during cardiopulmonary bypass.
• Neuromuscular blockade appeared to increase the risk of PPCs

Conclusions:

• PPCs are quite significant after cardiac surgery using cardiopulmonary bypass.
• Implementation of a ventilation strategy could decrease PPCs.