Research Article

Comparison of Different Ventilation Strategies during Cardiopulmonary Bypass in Smoker Patients Under Cardiac Surgery

Different ventilation strategies during cardiopulmonary bypass


Background: Control of pulmonary ventilation during surgery, especially heart surgery, is very important. Therefore, in this study, we will compare different ventilation strategies during cardiopulmonary bypass in smokers undergoing cardiac surgery.
Methods: A total of 42 patients who had a clinical indication for CABG were included in this study. Patients were randomly divided into two groups.  All patients were operated on by the same surgeon and cardiac anesthesia team in the same condition. The patient data includes age, sex, height, weight, and spirometry indices (FEV1, FVC, FEV1 / FVC, MMEF, PEF, PaO2, PaCO2, PaO2 / fio2, PaO2 / fio2, and Pent. T)  were recorded prospectively for each patient.
Results: Examines the spirometry indices of patients in the two groups in both pre-procedure and off-pump time, do not show significant changes (P<0.005).
Conclusion: The use of different ventilation strategies in smokers undergoing CABG surgery could not cause significant changes in patients' respiratory parameters.

[1] Ford ES, Ajani UA, Croft JB, Critchley JA, Labarthe DR, Kottke TE, et al. Explaining the decrease in US deaths from coronary disease, 1980–2000. N Engl J Med. 2007; 356(23):2388-98.
[2] Davoudi M, Farhanchi A, Moradi A, Bakhshaei MH, Safarpour G. The effect of low tidal volume ventilation during cardiopulmonary bypass on postoperative pulmonary function. J Tehran Heart Cent. 2010; 5(3):128.
[3] John LC, Ervine IM. A study assessing the potential benefit of continued ventilation during cardiopulmonary bypass. Interact Cardiovasc Thorac Surg. 2008; 7(1):14-7.
[4] Sepehripour AH, Lo TT, McCormack DJ, Shipolini AR. Is there benefit in smoking cessation prior to cardiac surgery?. Interact Cardiovasc Thorac Surg. 2012;15(4):726-32.
[5] Scherer M, Dettmer S, Meininger D, Deschka H, Geyer G, Regulla C, et al. Alveolar recruitment strategy during cardiopulmonary bypass does not improve postoperative gas exchange and lung function. Cardiovasc Eng. 2009; 9(1):1-5.
[6] Arozullah AM, Henderson WG, Khuri SF, Daley J. Postoperative mortality and pulmonary complication rankings: how well do they correlate at the hospital level?. Med Care. 2003; 41(8):979-91.
[7] Figueiredo LC, Araújo S, Abdala RC, Abdala A, Guedes CA. CPAP at 10 cm H2O during cardiopulmonary bypass does not improve postoperative gas exchange. Rev Bras Cir Cardiovasc. 2008;23(2):209-15.
[8] Mahjoubifard M, Heidari M, Dahmardeh M, Mirtajani SB, Jahangirifard A. Comparison of dexmedetomidine, lidocaine, and fentanyl in attenuation hemodynamic response of laryngoscopy and intubation in patients undergoing cardiac surgery. Anesthesiol Res Pract. 2020; 2020.
[9] Aneeshkumar S, Sundararajan L. Use of risk calculator in predicting postoperative respiratory failure in patients undergoing elective/emergency surgery at a tertiary care hospital in South India. Indian Journal of Respiratory Care. 2020; 9(1):47.
[10] Chi D, Chen C, Shi Y, Wang W, Ma Y, Zhou R, et al. Ventilation during cardiopulmonary bypass for prevention of respiratory insufficiency: A meta-analysis of randomized controlled trials. Medicine. 2017; 96(12):e6454.
[11] Wang YC, Huang CH, Tu YK. Effects of positive airway pressure and mechanical ventilation of the lungs during cardiopulmonary bypass on pulmonary adverse events after cardiac surgery: A systematic review and meta-analysis. J Cardiothorac Vasc Anesth. 2018; 32(2):748-759.
[12] Heinrichs J, Lodewyks C, Neilson C, Abou-Setta A, Grocott HP. The impact of hyperoxia on outcomes after cardiac surgery: a systematic review and narrative synthesis. Can J Anaesth. 2018;65(8):923-35.
[13] McGuinness SP, Parke RL, Drummond K, Willcox T, Bailey M, SO-COOL investigators. A multicenter, randomized, controlled phase IIb trial of avoidance of hyperoxemia during cardiopulmonary bypass. Anesthesiology. 2016;125(3):465-73.
[14] Swenne CL, Lindholm C, Borowiec J, Carlsson M. Surgical-site infections within 60 days of coronary artery by-pass graft surgery. J Hosp Infect. 2004; 57(1):14-24.
[15] Benedetto U, Albanese A, Kattach H, Ruggiero D, De Robertis F, Amrani M, et al. Smoking cessation before coronary artery bypass grafting improves operative outcomes. J Thorac Cardiovasc Surg. 2014; 148(2):468-74.
[16] Papathanasiou A, Milionis H, Toumpoulis L, Kalantzi K, Katsouras C, Pappas K, et al. Smoking cessation is associated with reduced long-term mortality and the need for repeat interventions after coronary artery bypass grafting. Eur J Cardiovasc Prev Rehabil. 2007; 14(3):448-50.
[17] Ladha K, Melo MF, McLean DJ, Wanderer JP, Grabitz SD, Kurth T, et al. Intraoperative protective mechanical ventilation and risk of postoperative respiratory complications: hospital-based registry study. Bmj. 2015;351.
[18] Nguyen LS, Merzoug M, Estagnasie P, Brusset A, Koune JD, Aubert S, et al. Low tidal volume mechanical ventilation against no ventilation during cardiopulmonary bypass heart surgery (MECANO): study protocol for a randomized controlled trial. Trials. 2017;18(1):1-6.
IssueVol 9 No 4 (2023): Autumn QRcode
SectionResearch Article(s)
Ventilation CABG cardiac surgery smoker patients

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How to Cite
Fani K, Abbasi M, Radmand G, jahangirifard A. Comparison of Different Ventilation Strategies during Cardiopulmonary Bypass in Smoker Patients Under Cardiac Surgery. Arch Anesth & Crit Care. 2023;9(4):329-332.