Severity of Chronic Obstructive Pulmonary Disease as A predictor Of Outcome after Coronary Artery Bypass Grafting Surgery | ||||
| Benha Journal of Applied Sciences | ||||
| Article 40, Volume 6, Issue 5, September 2021, Page 247-254 PDF (536.57 K) | ||||
| Document Type: Original Research Papers | ||||
| DOI: 10.21608/bjas.2021.205389 | ||||
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| Authors | ||||
| M.E. Sharaf1; M.A. El-Asal2; T.S. Esawy3; B.M. Aglan4 | ||||
| 1Critical care medicine Medicine, Dept., Nasser Institute for Research and Treatment, Cairo, Egypt. | ||||
| 2Internal medicine, Dept., Faculty of Medicine, Benha Univ., Benha, Egypt | ||||
| 3Pulmonology, Dept., Faculty of Medicine, Benha Univ., Benha, Egypt | ||||
| 4Cardiovascular surgery, Dept., Faculty of Medicine, Benha Univ., Benha, Egypt | ||||
| Abstract | ||||
| Context: COPD is an inflammatory illness of the airways, alveoli and microvasculature that shows persistent airflow limitation and small airways remodeling1. The pulmonary and systemic inflammation, changes in mucosal tissues, fibre and / or fibrous types, pulmonary vascular reshaping and angiogenesis are featured for the remodelling of the lungs1. Such pathological changes, in particular systemic inflammation and deregulated angiogenesis contribute to adverse effects in patients with COPD on different extrapulmonary organs. In clinical work, COPD is a common co-morbid disease in patients who are grafted by bypass of the coronary artery (CABG) with a 4-20.5-percent incidence. COPD has traditionally been recognised as a contraindication of CABG2 operation. COPD was reportedly associated with increased postoperative mortality and morbidity such as prolonged mechanical ventilation, breathing failure, and atrial fibrillation in patients indicated for CABG. Studies have shown various COPD effects on postoperative morbidity and death3. Mortality rates between mild and moderate COPD patients and those without COPD have been reported to be comparable, but only serious COPD is associated with an increased mortality risk. In addition, some studies have demonstrated that the death rate of CABG patients was not influenced by airflow obstructions and COPD was not an independent risk factor for higher mortality and morbidity rates4. Objective: The aim of this study was to assess postoperative results of patients undergoing grafting surgery with chronic obstructive pulmonary disease. Methodology: This was a cross-sectional study of 100 patients undergoing surgery and was prepared for CABG over 3 years and data were collected from the cardiothoracic surgery registry data base system at the University of Benha. The primary endpoint was that the lung function test was subject to severe restrictive changes and that the FVC, FEV1 and PEF were significantly reduced and Respiratory complications remain the main cause of post-cardial surgical morbidity and can prolong hospital stays and increase costs so that pre- and post-operative pulmonary function assessment should be performed as a routine in CABG patients, even if the patients are asymptomatic and Pulmonary function assessment pre and post-operative should be done as a routine in CABG surgery patients even if the patients are asymptomatic and strongly recommend After coronary artery, lung rehabilitation bypasses grafting of all patients after CABG. Results: 100 patients undergone and prepped for CABG surgery were recruited for this study over a period of three years.) Table 1(shows the included patient demographic data (n=100). After CABG, FEV1/FVC alterations in pulmonary function testing are both pre-operative and postoperative and are highly statistically significant (p = 0.000). In addition, the next 40% experienced after respiratory problems with moderate postoperative pleural effusion, 22% had postoperative atelectasis, and 8% had postoperative pneumonia, which was statistically important. Conclusion: severe, reversible lung function restriction changes occurred in COPD patients in the early postoperative period, with many pulmonary complications in COPD patients following CABG, and pre- and postoperative pulmonary functional evaluations should be carried out in routine patients undergoing CABG surgery, even if the patients are asymptomatic and CABG produces long-term changes. | ||||
| Keywords | ||||
| CABG; COPD; Pulmonary function | ||||
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