Açık Kalp Cerrahisinde Postoperatif Solunum Sistemi Komplikasyonlarının Preopratif, İntraopratif ve Postoperatif Belirleyicileri

Preoperative, Intraoperative and Postoperative Predictors of Postoperative Respiratory System Complications in Patients Undergoing Open Heart SurgeryObjective: The increasing prevalence of risky cardiac operations and the changing patient profile, can cause more problems during intraoperative and postoperative periods.Problems related to the respiratory system in the postoperative period are also the most important causes of increased mortality and morbidity rates. The aim of the study was to determine the preoperative, intraoperative, and postoperative predictors of the respiratory complications of open-heart surgery patients.Material and Methods: 1401 patients undergoing open-heart surgery between 2000-2005 were evaluated retrospectively. Patients’ age, sex, body mass index, preoperative laboratory tests, left ventricular ejection fractions (LVEF, %), comorbid diseases, use of β-blockers ,smoking,type and duration of operation, cardiopulmonary bypass and anesthesia, transfusion of blood intraoperatively, time of extubation, amounts of mediastional drainage, length of stay in the ICU and in the hospital were recorded. The relationship between these predictors and postoperative respiratory complications is investigated. Results: In our study, the prevalence rate of postoperative respiratory complications among patients undergoing openheart surgery was found to be 39.2 %. The most common complication was prolonged mechanical ventilation (36.1 %), while the least frequent complication was pneumothorax (0.6 %). The mortality rate due to respiratory complications was 3.3 %. Risk factors for respiratory complications included older age, female gender, smoking, hypertension, COPD, higher rates of concomitant operations, preoperative hematologic and biochemical abnormalities, prolonged duration of CPB, anesthesia, operative, and extubation times, length of ICU and hospital stay, extra need for intraoperative transfusion of blood products and increased mediastinal drainage. Conclusion: Detailed examination of the patients preoperatively, and optimal treatment, could decrease complications of anesthesia and mortality rates by preference for the appropriate fast-tract anesthesia method which shortens duration of surgery, anesthesia and CPB.