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Chest, Vol 95, 21-28, Copyright © 1989 by American College of Chest Physicians

ARTICLES

Expiratory mechanics before and after uncomplicated heart surgery

WA Zin, MP Caldeira, WV Cardoso, JO Auler Jr and PH Saldiva
Instituto do Coracao, Faculdade de Medicina da USP, Sao Paulo, Brazil.

In 12 mechanically ventilated anesthetized paralyzed patients undergoing cardiac surgery for either coronary bypass or for correcting valvular dysfunction volume, airflow, tracheal, esophageal, and transpulmonary pressures were measured. Respiratory system elastance and resistance were partitioned into their lung and chest wall components throughout tidal relaxed expiration. Measurements were performed prior to thoracotomy and just after rib cage closure. Before surgery, patients with valvular disease had significantly higher respiratory system and lung elastances and resistances than those with ischemic heart disease. After surgery, patients with valvular disease showed a decrease in respiratory system and lung resistances. Surgery strikingly modified chest wall resistive properties in both groups. Postoperatively, the mechanical properties of the respiratory system were very similar in valvular and ischemic patients.


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Copyright © 1989 by the American College of Chest Physicians.