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Respiratory function after cardiac surgery

D Johnson¹, T Hurst, D Thomson

¹Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Canada.

Journal of Cardiothoracic and Vascular Anesthesia

|August 1, 1996

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Postoperative cardiac surgery patients experience persistent declines in respiratory muscle strength and spirometry for up to 8 weeks. These physiological changes correlate with alterations in respiratory symptoms like cough and dyspnea.

Area of Science:

Pulmonary Medicine
Cardiothoracic Surgery
Respiratory Physiology

Background:

Cardiac surgery frequently leads to reduced respiratory muscle strength and spirometry.
Postoperative atelectasis is a common complication following cardiac procedures.
The specific respiratory symptoms linked to these physiological changes are not well-understood.

Purpose of the Study:

To investigate the relationship between postoperative respiratory physiological changes and patient-reported respiratory symptoms.
To determine the persistence of spirometry and respiratory muscle strength deficits up to 8 weeks after cardiac surgery.
To identify correlations between residual physiological impairments and specific respiratory symptoms.

Main Methods:

An observational cohort study involving 138 patients undergoing elective cardiac surgery.

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Measurement of spirometry (forced vital capacity, FEV1), respiratory muscle strength (negative inspiratory pressure), atelectasis, and pleural effusions from admission to 8-week follow-up.

Stepwise logistic regression analysis to compare physiological changes with respiratory symptoms (cough, wheeze, phlegm, dyspnea).

Main Results:

Spirometry and negative inspiratory pressure decreased, while atelectasis increased postoperatively, with incomplete resolution at 8 weeks.
A significant proportion of patients reported changes in cough, phlegm, wheeze, and dyspnea symptoms at 8 weeks.
Residual atelectasis and reduced negative inspiratory pressure at 8 weeks were predictive of dyspnea and cough symptoms; reduced forced vital capacity predicted wheeze.

Conclusions:

Respiratory muscle strength and spirometry deficits can persist for at least 8 weeks after cardiac surgery.
Many patients experience altered respiratory symptoms post-cardiac surgery, with symptom changes correlating to physiological impairments.
Residual respiratory muscle weakness, decreased spirometry, and atelectasis are linked to persistent or altered respiratory symptoms.