Investigation of the frequency and risk factors of pulmonary complications following cardiac surgery in the hospital
risk factors of pulmonary complications following cardiac surgery
DOI:
https://doi.org/10.22317/jcms.v9i2.1313Keywords:
Pulmonary complications, cardiovascular surgery, risk factors, Fresh frozen palsmaAbstract
Objective: The purpose of this study was to determine the frequency of pulmonary complications after heart surgery and to assess the pre-operative, intra-operative and post-operative risk factors.
Methods: This was a descriptive and analytical study that was conducted on 244 patients who underwent various cardiac surgeries from December 2021 to May 2022 in Shefa Kerman Hospital. This descriptive/analytical study on patients undergoing heart surgery at Shafa Hospital, Kerman, Iran, from December 2021 to May 2022. Pulmonary complications included atelectasis pneumonia, pleural effusion, long-term mechanical ventilation, and respiratory failure. The pre-operative, intra-operative and post-operative risk factors were investigated in the present study. SPSS software was used to analyze the data. Logistic regression analysis was employed to determine the relationship between risk factors and the incidence of lung complications.
Results: In the present study, 55 patients (22.5%) had pulmonary complications, followed by prolonged mechanical ventilation (13.1%), pneumonia (11.5%), respiratory failure (4.1%), pleural effusion (11.1%) and atelectasis (6.1%). Pulmonary complications after heart surgery were associated with days of ICU stay, post-operative stroke, post-operative acute kidney injury, emergency surgery, FFP injection, high drainage rate, and mitral valve replacement surgery (all p <0.001). 4% of patients died after surgery, which was statistically related to pulmonary complications (P<0.0001). The results of multivariable logistic regression test showed that FFP injection, type of heart surgery, hypertension, ICU stay days are capable of predicting pulmonary complications after heart surgery.
Conclusion: Mortality was found to be higher in patients with pulmonary complications. Based on the results of the regression analysis, FFP injection, type of surgery, history of hypertension and length of ICU stay were independent risk factors of pulmonary complications.
References
Tristan George Tanner, Mai O. Colvin. Pulmonary Complications of Cardiac Surgery. Lung (2020) 198:889–896
Wynne R, Botti M. Postoperative pulmonary dysfunction in adults after cardiac surgery with cardiopulmonary bypass: clinical significance and implications for practice. Am J Crit Care. 2004;13(5):384-93.
Mali S, Haghaninejad H. Pulmonary complications following cardiac surgery. Archives of Medical Sciences Atherosclerotic Diseases. 2019;4:e280.
Sabaté S, Mazo V, Canet J. Predicting postoperative pulmonary complications: implications for outcomes and costs. Current Opinion in Anesthesiology. 2014;27(2):201-9.
Gravlee GP. Cardiopulmonary bypass: principles and practice: Lippincott Williams & Wilkins; 2008.
Naveed A, Azam H, Murtaza HG, Ahmad RA, Baig MAR. Incidence and risk factors of pulmonary complications after cardiopulmonary bypass. Pakistan journal of medical sciences. 2017;33(4):993.
Miskovic A, Lumb A. Postoperative pulmonary complications. BJA: British Journal of Anaesthesia. 2017;118(3):317-34.
Canet J, Gallart L, Gomar C, Paluzie G, Valles J, Castillo J, et al. Prediction of postoperative pulmonary complications in a population-based surgical cohort. The Journal of the American Society of Anesthesiologists. 2010;113(6):1338-50.
Younossian AB, Adler D, Bridevaux P-O, Kherad O. Postoperative pulmonary complications: how to anticipate and prevent the risk? Revue Medicale Suisse.
Canver CC, Chanda J. Intraoperative and postoperative risk factors for respiratory failure after coronary bypass. The Annals of thoracic surgery. 2003;75(3):853-7.
Ji Q, Mei Y, Wang X, Feng J, Cai J, Ding W. Risk factors for pulmonary complications following cardiac surgery with cardiopulmonary bypass. International journal of medical sciences. 2013;10(11):1578.
Mathis MR, Duggal NM, Likosky DS, Haft JW, Douville NJ, Vaughn MT, et al. Intraoperative mechanical ventilation and postoperative pulmonary complications after cardiac surgery. Anesthesiology. 2019;131(5):1046-62.
Mali S, Haghaninejad H. Pulmonary complications following cardiac surgery. Archives of Medical Science-Atherosclerotic Diseases. 2019;4(1):280-5.
Sadeghi HA, Tabrizi RA, Ghadrdoost B, Azarfarin R. Evaluation of pulmonary complications in patients with valvular heart surgery: Clinical and laboratory significances. Res Cardiovasc Med. 2017;6(2):e39944.
Gupta S, Fernandes RJ, Rao JS, Dhanpal R. Perioperative risk factors for pulmonary complications after non-cardiac surgery. Journal of anaesthesiology, clinical pharmacology. 2020;36(1):88.
Saadah NH, van der Bom JG, Wiersum‐Osselton JC, Richardson C, Middelburg RA, Politis C, et al. Comparing transfusion reaction risks for various plasma products–an analysis of 7 years of ISTARE haemovigilance data. British Journal of Haematology. 2018;180(5):727-34.
Khan H, Belsher J, Yilmaz M, Afessa B, Winters JL, Moore SB, et al. Fresh-frozen plasma and platelet transfusions are associated with development of acute lung injury in critically ill medical patients. Chest. 2007;131(5):1308-14.
Sarani B, Dunkman WJ, Dean L, Sonnad S, Rohrbach JI, Gracias VH. Transfusion of fresh frozen plasma in critically ill surgical patients is associated with an increased risk of infection. Critical care medicine. 2008;36(4):1114-8.
Bochicchio GV, Napolitano L, Joshi M, Bochicchio K, Shih D, Meyer W, et al. Blood product transfusion and ventilator-associated pneumonia in trauma patients. Surgical infections. 2008;9(4):415-22
Desborough MJR, Sandu R, Brunskill SJ, Doree C, Trivella M, Montedori A, Abraha I, Stanworth SJ. Fresh frozen plasma for cardiovascular surgery. Cochrane Database of Systematic Reviews 2015, Issue 7. Art. No.: CD007614. DOI: 10.1002/14651858.CD007614.pub2.
Cavayas YA, Eljaiek R, Rodrigue É, Lamarche Y, Girard M, Wang HT, et al. Preoperative diaphragm function is associated with postoperative pulmonary complications after cardiac surgery. Critical Care Medicine. 2019;47(12):e966-e74
Gontse Leballo, Hlamatsi Jacob Moutlana, Michel Kasongo Muteba, Palesa Motshabi Chakane.Factors associated with acute kidney injury and mortality during cardiac surgery Gontse Leballo, Hlamatsi Jacob Moutlana, Michel Kasongo Muteba, Palesa Motshabi Chakane
CARDIOVASCULAR JOURNAL OF AFRICA 2021;32(6):313-318.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Journal of Contemporary Medical Sciences
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.