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Abstract: Poster Presentations |

ACUTE PLEURAL-PULMONARY ALTERATIONS AFTER CABG (CORONARY ARTERY BYPASS GRAFT) FREE TO VIEW

Marcelo A. Vaz, MD*; Daniela B. Mont’alverne; Maria I. Feltrim; Lisete R. Teixeira, MD; Francisco S. Vargas, MD
Author and Funding Information

Heart Intitute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil


Chest


Chest. 2005;128(4_MeetingAbstracts):361S-a-362S. doi:10.1378/chest.128.4_MeetingAbstracts.361S-a
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Abstract

PURPOSE:  Evaluate the changes over pulmonary mechanics and pleural effusion in the first six days after CABG.

METHODS:  We analyze FVC, Maximum Inspiratory Pressure (PImax), Maximum Expiratory Pressure (PEmax) daily until the 6th day after CABG, and Atelectasis and pleural effusion (X-ray and CT) on the 6th day after CABG. It was studied 60 patients consecutively after CABG. Lower lobe atelectasis at X-ray was scored (0 = no atelectasis; 1 = plate-like atelectasis; 2 = atelectasis of a single segment; 3 = atelectasis of more than one segment; 4 = lobar atelectasis). Pleural effusion on X-ray was scored (0 = no pleural effusion; 1 = blurring of the costo-phrenic angle; 2 = effusion occupying one to two intercostal spaces; 3 = effusion occupying more than two intercostal spaces). Pleural effusion volume on computerized tomography was estimated through the formula d 2 x l 2, where d = greatest depth of the effusion on a single CT image and l = greatest length of the effusion. Were considered significant p<0.05.

RESULTS:  Were observed a decline in PImax, PE max and FVC in the 1st day after CABG, with a slow recovery over the first six days after the CABG (Graphic1). On X-Ray there were a high frequence of atelectasis (70% of the patients)and pleural effusion (83% of the patients), and CT scan revealed a greater amount of atelectasis(92%), when compared with X-ray. The estimated volume of pleural effusion on the 6th day after CABG was 73.72 +/- 188.31 ml (rigth side) and 258.72 +/- 400.62 ml (left side).

CONCLUSION:  CABG induces a deep decline of strength and volumes (bigger than 50% of decline)acutelly after the surgery. This procedure will leave an amount of pleural effusion and atelectasis on the 6th day after the surgery.

CLINICAL IMPLICATIONS:  Despite we do not observe major complications after CABG, these procedure may be harmful for patients with pulmonary impairment, or lung disease before the surgery.

DISCLOSURE:  Marcelo Vaz, None.

Wednesday, November 2, 2005

12:30 PM - 2:00 PM


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