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A study assessing the potential benefit of continued ventilation during cardiopulmonary bypass

^a Department of Cardiothoracic Surgery, Kings College Hospital, Denmark Hill, London SE5 9RS, UK
^b Department of Intensive Care Medicine, Kings College Hospital, Denmark Hill, London SE5 9RS, UK

*Corresponding author. Tel.: +44 20 3299 4365; fax: +44 20 3299 3433.

E-mail address: lindsay.john{at}kingsch.nhs.uk (L.C.H. John).

It has been suggested that maintaining ventilation during bypass might reduce lung injury, which is a common complication of cardiac surgery. In order to assess this, a study is being undertaken to examine the effect upon a number of parameters that may be indicative of lung injury, of continued ventilation compared with discontinued ventilation whilst on bypass. The following parameters have been assessed: extravascular lung water, static and dynamic compliance, ratio of left atrial/right atrial white blood count, alveolar arterial oxygen gradient and the respiratory index together with clinical end points. Provisional results are reported. Twenty-three elective patients for coronary artery surgery have to date been randomised to either ventilation (VB) (n=12) or non-ventilation on bypass (NVB) (n=11). The post-bypass extravascular lung water was significantly smaller in the VB group compared to the NVB group (530±50 ml vs. 672±32 ml; P=0.028). Extubation time was also significantly shorter in the VB group (3.6±0.3 h vs. 4.8±0.4 h; P=0.038). The provisional results of this work in progress are suggestive that continued ventilation during bypass may reduce lung injury.

Key Words: Acute lung injury; Cardiac surgery; Cardiopulmonary bypass; Ventilation; Extravascular lung water

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