[Changes in respiratory mechanics after cardiac surgery]

Cardiac surgery involves a complex of factors adversely affecting the pulmonary function (PF). Among them mainly pleurotomy and hypothermic phrenic nerve injury may potentially deteriorate postoperative PF. In a prospective study of 236 patients undergoing cardiac surgery, pre-, early and late postoperative PFs were evaluated. The impact of different techniques of coronary artery bypass grafting, of pleurotomy and diaphragmatic dysfunction and the effect of COPD on the postoperative modification of PF was investigated. The analysis revealed a substantial impairment of postoperative PF especially when pleural cavity was entered, the patients had COPD history, diaphragmatic dysfunction, or multiple pulmonary complications were present. These aspects should be considered in optimizing the pre-, per- and postoperative management of cardiac patients. (Tab. 5, Fig. 6, Ref. 34.)