Evaluate the changes over pulmonary mechanics and pleural effusion in the first six days after CABG.
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.
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).
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.
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.
Marcelo Vaz, None.