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Interact CardioVasc Thorac Surg 2008;7:17. doi:10.1510/icvts.2007.158451A © 2008 European Association of Cardio-Thoracic Surgery
A study assessing the potential benefit of continued ventilation during cardiopulmonary bypassBakoulev Scientific Center for Cardiovascular Surgery, Rublevskoe Shosse 135, Moscow 121552, Russia A study assessing the potential benefit of continued ventilation during cardiopulmonary bypass Factors playing the most significant role in the pathogenesis of acute lung injury (ALI) include character and intensity of the injuring factor, genetic predisposition, impaired immunity, attendant pathology, systemic inflammatory response (SIRS) and development of multiorgan failure. Despite the presence of definite features in each aetiological factor, the primary trigger of the development of ALI is SIRS affecting lung tissue. Lung injury after cardiac surgery and cardiopulmonary bypass (CPB) is a sufficiently severe complication. Study of interrelation between respiratory mechanics, extravascular lung water (EVLW) and pulmonary oxygenation is undoubtedly of great scientific interest. The data presented by the authors do not allow to make straight conclusions which of the lung ventilation methods during CPB is more or less advantageous, and this doesn't contradict the authors' results [1]. Frequency of intraoperative respiratory complications is quite low in the case of uncomplicated course of cardiac surgery. Thoracic epidural anesthesia (naropin) is added to our practice, which allows to shorten postoperative ventilation time significantly among this category of patients. More than 60% of the patients similar to the category presented by the authors are extubated on the surgery table during the first postoperative hour. Patients transported to the intensive care unit (ICU) are extubated for three hours after surgery in our practice.
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