Document Detail


Arterial blood gases after coronary artery bypass surgery.
MedLine Citation:
PMID:  1424847     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Coronary artery bypass graft (CABG) surgery adversely affects arterial blood gas (ABG) determinations. The purposes of this study were to assess serial changes in ABGs following bypass surgery and identify factors that may influence these changes. Room air ABGs were obtained preoperatively and on days 1, 2, 4, 6, and 8 postoperatively on 125 patients undergoing bypass surgery. Fifty-five patients (saphenous vein grafting [SVG] group) had only SVG grafting while 70 (internal mammary artery [IMA] group) received one (60 patients) or two (10 patients) IMA grafts in addition to the SVG grafts and were subjected to pleurotomy. The mean preoperative values (+/- SD) were as follows: PaO2, 75.1 +/- 7.7 mm Hg, P(A-a)O2, 20.9 +/- 7.5 mm Hg; PaCO2, 33.6 +/- 4.1 mm Hg; pH, 7.43 +/- 0.04; hemoglobin, 14.8 +/- 1.4 g/dl; and hematocrit, 44.2 +/- 3.9 percent. There was a large decrease in the PaO2 postoperatively. The nadir for the PaO2 (55.7 +/- 6.6 mm Hg) occurred on the second postoperative day. Eight days postoperatively, there were still significant abnormalities; the PaO2 was 65.7 +/- 7.3 mm Hg, the P(A-a)O2 was 33.2 +/- 8.8 mm Hg; the hemoglobin was 10.5 +/- 1.4 g/dl; and the hematocrit was 31.7 +/- 4.0 percent. The decrease in the PaO2 was particularly noteworthy given the large decrease in the hemoglobin and hematocrit. The changes in the PaO2 were not significantly correlated with the age, number of grafts, pump time, length of anesthesia, or endotracheal intubation or smoking history. Immediately postoperatively, changes were similar in both groups (p > 0.05); on the second postoperative day, the PaO2 had decreased 26.9 percent in the SVG group and 25.5 percent in the IMA group. However, the postoperative abnormalities resolved more slowly in the IMA group (p < 0.05). These observations suggest that the additional trauma to the lungs and chest wall in the IMA group (pleurotomy, the placing of pleural drains, etc) will result in a longer recovery time in the IMA group than in SVG group.
Authors:
N P Singh; F S Vargas; A Cukier; M Terra-Filho; L R Teixeira; R W Light
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  102     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1992 Nov 
Date Detail:
Created Date:  1992-12-04     Completed Date:  1992-12-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1337-41     Citation Subset:  AIM; IM    
Affiliation:
Instituto do Coraçao, Faculty of Medicine, University of Sao Paulo, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Carbon Dioxide / blood*
Coronary Artery Bypass / adverse effects*
Hematocrit
Hemoglobins / analysis
Humans
Internal Mammary-Coronary Artery Anastomosis
Middle Aged
Oxygen / blood*
Postoperative Complications
Pulmonary Gas Exchange
Saphenous Vein / transplantation
Chemical
Reg. No./Substance:
0/Hemoglobins; 124-38-9/Carbon Dioxide; 7782-44-7/Oxygen
Comments/Corrections
Comment In:
Chest. 1992 Nov;102(5):1313-4   [PMID:  1424838 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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