Effects of ventilation during cardiopulmonary bypass on postoperative pulmonary complications

Obejctive: We aimed to compare the Postoperative Pulmonary Complication Score (PPCs) and Modified Pulmonary Infection Score (mCPIS) of patients who were ventilated and not ventilated during cardiopulmonary bypass in coronary artery graft surgery. We also intend to compare the postoperative blood gas values, extubation times, intensive care and hospital stays of the groups. Materials and Methods: Our study included 64 patients aged 18-70 years who had undergone coronary artery grafting surgery, 32 of those patients were ventilated during cardiopulmonary bypass (Group V) while other 32 were not ventilated (Group N). Demographic data (age, gender, ASA score, height, weight, body mass index (BMI) and smoking) of the patients were recorded. In Group V, patients were ventilated with a tidal volume of 3-4 ml/kg during the cardiopulmonary bypass. 5 cmH2O PEEP was applied to the patients in this group. Group N was not ventilated during the cardiopulmonary bypass. After the surgery patients was transferred to the intensive care unit intubated. PPC score and mCPISN score were evaluated at the 24th hour after intubation. In addition, blood gas values were recorded at the 1st, 6th, 12th and 24th hours after admission to the intensive care unit. The extubation times of the patients, the length of stay in the intensive care unit, and the length of stay in the ward were also recorded. Findings: There was no difference between the two groups in terms of demographic data (p>0.05). PPCs and mCPIS values were statistically significantly lower in Group V compared to Group N (p<0.05). The amount of preoperative albumin and the amount of crystalloid given intraoperatively were statistically significantly lower in Group V than in Group N (p<0.05). In the postoperative 6th, 12th and 24th hour blood gas PaO2 was significantly higher in Group V than in Group N (p<0.05). Mechanical ventilation time, extubation time, intensive care unit stay and hospital stay of the patients were found to be statistically significantly lower in patients who were ventilated in CPB compared to those who were not ventilated. Result: This study demonstrated that ventilation during cardiopulmonary bypass can reduce or prevent the occurrence of postoperative pulmonary complications. As a result, it has been shown that patients can provide shorter mechanical ventilation time, extubation time, sooner intensive care and hospital discarge. Keywords: Cardiopulmonary bypass, Postoperative Pulmonary Complication, Mechanical Ventilation