Associations Between Expiratory Flow Limitation and Postoperative Pulmonary Complications in Patients Undergoing Cardiac Surgery
1
Issued Date
2022-03-01
Resource Type
ISSN
10530770
eISSN
15328422
Scopus ID
2-s2.0-85112556796
Pubmed ID
34404594
Journal Title
Journal of Cardiothoracic and Vascular Anesthesia
Volume
36
Issue
3
Start Page
815
End Page
824
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Cardiothoracic and Vascular Anesthesia Vol.36 No.3 (2022) , 815-824
Suggested Citation
Ball L. Associations Between Expiratory Flow Limitation and Postoperative Pulmonary Complications in Patients Undergoing Cardiac Surgery. Journal of Cardiothoracic and Vascular Anesthesia Vol.36 No.3 (2022) , 815-824. 824. doi:10.1053/j.jvca.2021.07.035 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/86106
Title
Associations Between Expiratory Flow Limitation and Postoperative Pulmonary Complications in Patients Undergoing Cardiac Surgery
Author(s)
Other Contributor(s)
Abstract
Objectives: To determine whether driving pressure and expiratory flow limitation are associated with the development of postoperative pulmonary complications (PPCs) in cardiac surgery patients. Design: Prospective cohort study. Setting: University Hospital San Raffaele, Milan, Italy. Participants: Patients undergoing elective cardiac surgery. Measurements and Main Results: The primary endpoint was the occurrence of a predefined composite of PPCs. The authors determined the association among PPCs and intraoperative ventilation parameters, mechanical power and energy load, and occurrence of expiratory flow limitation (EFL) assessed with the positive end-expiratory pressure test. Two hundred patients were enrolled, of whom 78 (39%) developed one or more PPCs. Patients with PPCs, compared with those without PPCs, had similar driving pressure (mean difference [MD] –0.1 [95% confidence interval (CI), –1.0 to 0.7] cmH2O, p = 0.561), mechanical power (MD 0.5 [95% CI, –0.3 to 1.1] J/m, p = 0.364), and total energy load (MD 95 [95% CI, –78 to 263] J, p = 0.293), but they had a higher incidence of EFL (51% v 38%, p = 0.005). Only EFL was associated independently with the development of PPCs (odds ratio 2.46 [95% CI, 1.28-4.80], p = 0.007). Conclusions: PPCs occurred frequently in this patient population undergoing cardiac surgery. PPCs were associated independently with the presence of EFL but not with driving pressure, total energy load, or mechanical power.