Comprehensive lung protection during circulatory arrest in aortic arch surgery

Aim. The aim of the study was to analyze the effectiveness of  comprehensive lung protection in patients who underwent thoracic aortic surgery using circulatory arrest. Material and Methods. A total of 57 patients undergoing operations for aneurysms and thoracic aortic dissection were enrolled in the prospective study. The patients were divided into two groups. The experimental group of patients ( n = 27) underwent comprehensive lung protection with pulmonary artery perfusion and mechanical ventilation. Patients in the control group ( n = 30) did not undergo comprehensive lung protection measures. Results. The median duration of mechanical ventilation in the postoperative period was 14 hours in the experimental group and 23 hours in the control group of patients ( p < 0.001). The incidence of analyzed pulmonary complications did not significantly differ between the groups during the early postoperative period. The number of pneumonia cases was 8 (14%) including 4 (15%) cases in the experimental group and 4 (13%) episodes in the control group ( p = 0.87). Conclusion. Selective pulmonary artery perfusion in combination with low tidal volume mechanical ventilation during operations on the thoracic aorta using circulatory arrest significantly reduced the duration of postoperative  mechanical ventilation.