Prevalence and Implications of Abnormal Respiratory Patterns in Cardiac Surgery: A Prospective Cohort Study

Dmitry Ponomarev, Oksana Kamenskaya, Asya Klinkova, Irina Loginova, Vladimir Lomivorotov, Igor Kornilov, Vladimir Shmyrev, Aleksander Chernavskiy, Giovanni Landoni, Aleksander Karaskov

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Objective To investigate the prevalence and impact of abnormal respiratory patterns in cardiac surgery patients. Design Prospective cohort study. Setting Tertiary hospital. Participants Patients scheduled for elective coronary artery bypass graft surgery. Interventions None. Measurements and Main Results Pulmonary function tests were performed in 454 patients before surgery. Abnormal respiratory patterns were defined as follows: obstructive (forced expiratory volume in 1 s [FEV1]/forced vital capacity [FVC]<0.70), restrictive (FEV1/FVC≥0.70 and FVC<80% of predicted), and mixed (FEV1/FVC<0.70 and both FEV1 and FVC<80% of predicted). Of the 31 patients with a history of chronic obstructive pulmonary disease, no abnormal respiratory pattern was confirmed in 5. Of the 423 patients without a history of lung disease, the authors newly identified 57 obstructive, 46 restrictive, and 4 mixed patterns. Therefore, lung disease was reclassified in 24.7% of cases. Independent predictors of obstructive pattern were age, male sex, history of smoking, and chronic obstructive pulmonary disease. Obstructive lung disease was associated with 16 hours or longer ventilation. A reduced FEV1 was associated with a likelihood of atrial fibrillation (1-L decrement, odds ratio: 1.38, 95% confidence interval: 1.01-to-1.90, p = 0.04) and hospitalization time (regression coefficient: 1.23, 95% confidence interval: 0.54-to-1.91, p<0.001). Conclusions Abnormal respiratory patterns are common and often underdiagnosed in the cardiac surgery setting. Pulmonary function tests help reveal patients at risk of complications and may provide an opportunity for intervention.

Original languageEnglish (US)
Pages (from-to)2010-2016
Number of pages7
JournalJournal of cardiothoracic and vascular anesthesia
Volume31
Issue number6
DOIs
StatePublished - Dec 2017

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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