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Terbutaline improves efficiency of oxygenation after coronary artery bypass surgery
1Department of Cardiothoracic Surgery, Killingbeck Hospital, Leeds, UK.
Objective:
To assess the therapeutic role of the betareceptor agonist terbutaline in reducing postoperative pulmonary dysfunction following coronary artery bypass grafting (CABG).
Design:
Prospective, randomized, open controlled study.
Setting:
Cardiac surgical intensive care unit. PATIENTS. 22 consecutive patients undergoing elective CABG.
Interventions:
11 were randomized to receive terbutaline 0.5 mg subcutaneously 6 hourly for 48 hours following extubation (group T) while 11 controls did not (group C).
Measures:
FVC, FEV1 and PEFR measured pre-operatively and at 30 min, 12 hrs, 36 hrs and 5 days post-extubation. A-aDO2 calculated from arterial blood gas analysis during the first 24 hrs post-CABG.
Results:
Terbutaline had no effect on spirometric variables which decreased by over 50% after extubation in both groups and increased in similar fashion over the next 5 days. A-aDO2 increased significantly (p<0.01) after extubation in both groups. Treatment with terbutaline eliminated this change in group T at 6 hrs after extubation.
Conclusions:
Terbutaline has little effect on the restrictive ventilatory deficit after CABG but does improve the efficiency of oxygenation in the early postoperative period.