Original ArticlesEffect of cardiopulmonary bypass on pulmonary gas exchange: a prospective randomized study
Section snippets
Patient selection
Fifty-two patients undergoing elective CABG were enrolled in the study. Patients were prospectively randomized into two groups: a “CPB Group,” who underwent conventional myocardial revascularization with normothermic CPB and cardioplegic arrest of the heart with intermittent antegrade warm blood cardioplegia; and a “non-CPB Group,” who underwent revascularization on the beating heart. Exclusion criteria were as follows: known pulmonary disease, smoking within previous 6 months, poor left
Results
There were no significant differences in the patient characteristics or operative details between the two groups Table 1, Table 2. Chest tube drainage and volume of fluid administered during the first 24 hours postoperatively were significantly less in the non-CPB group (Table 3).
There was no significant difference between the two groups in the baseline A-a gradient measured before induction of anesthesia (CPB group 19.5 ± 6.2 mm Hg; non-CPB group 16.9 ± 5.1 mm Hg, mean ± SD). Similarly, there
Comment
The desire to minimize complications associated with CPB, as well as the current trend towards cost containment [7], has led to renewed interest in CABG without the use of CPB 4, 8. Brasil and colleagues [3] have shown that the inflammatory response associated with cardiac surgery using CPB is virtually undetectable in surgery performed without CPB. Despite this, only few studies have looked at the effects on end-organ function in association with procedures without CPB. Most studies have
Acknowledgements
We thank Andrew M. S. Black, FRCA, for his advice and practical assistance with the statistical analysis.
This study was supported by the British Heart Foundation and the Sir Sigmund Warburg Voluntary Settlement Fund.
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