Acute pleuropulmonary complications detected by computed tomography following myocardial revascularization
Rev. Hosp. Clin. Fac. Med. Univ. Säo Paulo
;
57(4): 135-142, July-Aug. 2002. tab
Article
Dans Anglais
| LILACS
| ID: lil-317581
RESUMO
INTRODUCTION:
Pleuropulmonary changes are common following coronary artery bypass grafting surgery performed with a saphenous vein graft, with or without an internal mammary artery. The presence of atelectasis or pleural effusions reflects the thoracic trauma.PURPOSE:
To define the postoperative incidence of changes in the lung and in the pleural space and to evaluate the influence of the trauma.METHODS:
Thirty patients underwent elective coronary artery bypass grafting surgery (8 saphenous vein grafts and 22 saphenous vein grafts and internal mammary artery grafts with pleurotomy). Chest tubes in the left pleural space were used in all internal mammary artery patients. On the second (day 2) and seventh (day 7) postoperative day, patients underwent a computed tomography, and pleural effusions were rated as follows grade 0 = no fluid to grade 4 = fluid in more than 75 percent of the hemithorax. Atelectasis was rated as follows laminar = 1, segmental = 3, and lobar = 10 points.RESULTS:
All patients had pleural effusion or atelectasis. Between day 2 and day 7, the number of patients with effusions or atelectasis on the right side decreased (P < 0.05). The incidence of effusions on day 2 in the saphenous vein graft group (87.5 percent) was higher (P < 0.05) than in the internal mammary artery group (52.3 percent). The incidence of atelectasis in the lower right lobe decreased (P < 0.05) from 86.7 percent (day 2) to 26.7 percent (day 7). The degree of atelectasis in both sides did not differ on day 2 (P = 0.42) but did on day 7 (P < 0.0001). There was a decrease in the atelectasis from day 2 to day 7 on the right side (P < 0.001), but not on the left (P = 0.21). On day 2 there was a relationship between atelectasis and effusion on the right (P = 0.04), but not on the left (P = 0.113).CONCLUSION:
The present series demonstrates that there is a high incidence of both minimal pleural effusion and atelectasis after coronary artery bypass grafting surgery, which drops on the right side from day 2 to day 7 post surgery. Factors that contribute to the persistence of changes on the left side include the thoracic trauma and the presence of chest tubes and pericardial effusion
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Épanchement pleural
/
Complications postopératoires
/
Atélectasie pulmonaire
/
Tomodensitométrie
/
Revascularisation myocardique
Type d'étude:
Etude d'incidence
/
Étude de prévalence
/
Étude pronostique
/
Facteurs de risque
Limites du sujet:
Femelle
/
Humains
/
Mâle
Pays comme sujet:
Amérique du Sud
/
Brésil
langue:
Anglais
Texte intégral:
Rev. Hosp. Clin. Fac. Med. Univ. Säo Paulo
Thème du journal:
Médicament
Année:
2002
Type:
Article
Pays d'affiliation:
Brésil
Institution/Pays d'affiliation:
University of Säo Paulo/BR
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