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Hemoadsorption during Cardiopulmonary Bypass in Patients with Endocarditis Undergoing Valve Surgery: A Retrospective Single-Center Study
 
 
Article

Postoperative Changes in Pulmonary Function after Valve Surgery: Oxygenation Index Early after Cardiopulmonary Is a Predictor of Postoperative Course

1
Department of Cardiovascular Surgery, Nippon Medical School Musashikosugi Hospital, Kawasaki 211-8533, Japan
2
Tokyo Heart Center Osaki Hospital, 5-4-12 Kitashinagawa, Shinagawa-ku, Tokyo 141-0001, Japan
*
Author to whom correspondence should be addressed.
Academic Editors: Francesco Onorati, Francesco Nicolini and Eduard Quintana
J. Clin. Med. 2021, 10(15), 3262; https://doi.org/10.3390/jcm10153262
Received: 28 June 2021 / Revised: 16 July 2021 / Accepted: 22 July 2021 / Published: 23 July 2021
(This article belongs to the Special Issue New Perspectives in Cardiovascular Surgery)
Objective: To determine pulmonary functional changes that predict early clinical outcomes in valve surgery requiring long cardiopulmonary bypass (CPB). Methods: This retrospective study included 225 consecutive non-emergency valve surgeries with fast-track cardiac anesthesia between January 2014 and March 2020. Blood gas analyses before and 0, 2, 4, 8, and 14 h after CPB were investigated. Results: Median age and EuroSCORE II were 71.0 years (25–75 percentile: 59.5–77.0) and 2.46 (1.44–5.01). Patients underwent 96 aortic, 106 mitral, and 23 combined valve surgeries. The median CPB time was 151 min (122–193). PaO2/FiO2 and AaDO2/PaO2 significantly deteriorated two hours, but not immediately, after CPB (both p < 0.0001). Decreased PaO2/FiO2 and AaDO2/PaO2 were correlated with ventilation time (r2 = 0.318 and 0.435) and intensive care unit (ICU) (r2 = 0.172 and 0.267) and hospital stays (r2 = 0.164 and 0.209). Early and delayed extubations (<6 and >24 h) were predicted by PaO2/FiO2 (377.2 and 213.1) and AaDO2/PaO2 (0.683 and 1.680), measured two hours after CPB with acceptable sensitivity and specificity (0.700–0.911 and 0.677–0.859). Conclusions: PaO2/FiO2 and AaDO2/PaO2 two hours after CPB were correlated with ventilation time and lengths of ICU and hospital stays. These parameters suitably predicted early and delayed extubations. View Full-Text
Keywords: cardiopulmonary bypass; lung injury; valve surgery; prolonged ventilation; early extubation cardiopulmonary bypass; lung injury; valve surgery; prolonged ventilation; early extubation
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MDPI and ACS Style

Murata, T.; Maeda, M.; Amitani, R.; Hiromoto, A.; Shirakawa, M.; Kambe, M.; Maruyama, Y.; Imura, H. Postoperative Changes in Pulmonary Function after Valve Surgery: Oxygenation Index Early after Cardiopulmonary Is a Predictor of Postoperative Course. J. Clin. Med. 2021, 10, 3262. https://doi.org/10.3390/jcm10153262

AMA Style

Murata T, Maeda M, Amitani R, Hiromoto A, Shirakawa M, Kambe M, Maruyama Y, Imura H. Postoperative Changes in Pulmonary Function after Valve Surgery: Oxygenation Index Early after Cardiopulmonary Is a Predictor of Postoperative Course. Journal of Clinical Medicine. 2021; 10(15):3262. https://doi.org/10.3390/jcm10153262

Chicago/Turabian Style

Murata, Tomohiro, Motohiro Maeda, Ryosuke Amitani, Atsushi Hiromoto, Makoto Shirakawa, Masaru Kambe, Yuji Maruyama, and Hajime Imura. 2021. "Postoperative Changes in Pulmonary Function after Valve Surgery: Oxygenation Index Early after Cardiopulmonary Is a Predictor of Postoperative Course" Journal of Clinical Medicine 10, no. 15: 3262. https://doi.org/10.3390/jcm10153262

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