Document Detail


Preservation of pleural integrity in patients undergoing coronary artery bypass grafting: effect on postoperative bleeding and respiratory function.
MedLine Citation:
PMID:  16485738     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this study was to evaluate the influence of preserved integrity of pleura on postoperative bleeding and respiratory function in patients undergoing coronary artery bypass grafting (CABG). METHODS AND RESULTS: Seventy-two CABG patients who received pedunculated IMA graft without opening the pleura (group of intact pleura, group IP) between July 2002 and September 2004 were matched to 72 CABG patients who received pedunculated IMA graft with opened pleura (group of opened pleura, group OP). To match the patients with IP and unique patients with OP, logistic regression was used to develop a propensity score. The C statistic for this model was 0.79. Patients with IP were matched to unique patients with OP with an identical 5-digit propensity score. If this could not be done, we proceeded to a 4-, 3-, 2-, or 1-digit match. Patients characteristics were well matched. There were no differences in preoperative and peroperative variables between the groups. The incidence of postoperative pleural effusion and thoracentesis were significantly lower in group IP than group OP (pleural effusion in 15.2 versus 30.5%; p = 0.029, thoracentesis in 5.5 versus 18.5%; p = 0.036). Other pulmonary complications such as prolonged ventilation, reintubation, pneumothorax, atelectasis, diaphragmatic paralysis were similar in both groups. Patients with IP had significantly lower blood loss (520 versus 870 ml; p < 0.001) and whole blood unit transfusion (26.3 versus 41.6%, p = 0.036). Also, intensive care unit and hospital stay were similar in both groups. CONCLUSIONS: Meticulous internal mammary artery harvesting and preservation of the pleural integrity significantly reduces postoperative bleeding and pleural effusion.
Authors:
Ibrahim Goksin; Ahmet Baltalarli; Mustafa Sacar; Hulya Sungurtekin; Vefa Ozcan; Ercan Gurses; Seyda Kaya; Harun Evrengul
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta cardiologica     Volume:  61     ISSN:  0001-5385     ISO Abbreviation:  Acta Cardiol     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-02-20     Completed Date:  2006-06-02     Revised Date:  2009-06-11    
Medline Journal Info:
Nlm Unique ID:  0370570     Medline TA:  Acta Cardiol     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  89-94     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Pamukkale University Faculty of Medicine, Heart Center, Kinikli/Denizli, Turkey. ibrahimgoksin@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Chi-Square Distribution
Coronary Artery Bypass*
Female
Hemorrhage / epidemiology,  etiology*
Hospital Mortality
Humans
Incidence
Internal Mammary-Coronary Artery Anastomosis
Logistic Models
Lung Diseases / epidemiology,  etiology*
Male
Pleura / surgery*
Pleural Effusion / epidemiology,  etiology*
Postoperative Complications / epidemiology,  etiology*
Prospective Studies
Respiratory Function Tests
Statistics, Nonparametric

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


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