The effects of cardiopulmonary bypass on pulmonary function during robotic cardiac surgery. 2015

G Wang, and S Xiao, and C Gao
PLA Institute of Cardiac Surgery, PLA General Hospital, Beijing, China.

BACKGROUND We aimed to investigate the effects of cardiopulmonary bypass (CPB) on pulmonary function under the conditions of one-lung ventilation (OLV) and carbon dioxide pneumothorax in robotic cardiac surgery. METHODS Ninety-eight patients underwent robotic cardiac surgery using the da Vinci Surgical System, including 58 on-pump surgeries and 40 off-pump surgeries. Respiratory parameters and arterial blood gases were assessed at the following time points: 25 min after the induction of anesthesia under two-lung ventilation (T1), 25 min after OLV (T2), 25 min after the termination of CPB under OLV in the on-pump group or 25 min after the main surgery intervention in the off-pump group (T3) and 20 min before the end of surgery (T4). Dynamic lung compliance (Cdyn), alveolar-arterial PO2 difference (PA-aDO2), oxygenation index (OI) and artery-alveolar O2 pressure ratio (a/A) were calculated. RESULTS No significant differences in pulmonary function parameters between T2 and T3 were observed in the off-pump group. However, in the on-pump group, compared with those at T2, PETCO2, Ppeak, PaCO2 and PA-aDO2 at T3 were higher, whereas SpO2, Cdyn, PaO2, OI and a/A were lower (p<0.05). Comparisons between the two groups at T3 indicated that SpO2, Cdyn, PaO2, OI and a/A were higher, while Ppeak, PaCO2 and PA-aDO2 were lower in the off-pump group (p<0.01). CONCLUSIONS In robotic cardiac surgery under the conditions of OLV and carbon dioxide pneumothorax, CPB worsened pulmonary function and tolerance to OLV and carbon dioxide pneumothorax.

UI MeSH Term Description Entries
D008168 Lung Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood. Lungs
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011031 Pneumothorax, Artificial Injection of air or a more slowly absorbed gas such as nitrogen, into the PLEURAL CAVITY to collapse the lung. Artificial Pneumothorax,Artificial Pneumothoraxs,Pneumothoraxs, Artificial
D012129 Respiratory Function Tests Measurement of the various processes involved in the act of respiration: inspiration, expiration, oxygen and carbon dioxide exchange, lung volume and compliance, etc. Lung Function Tests,Pulmonary Function Tests,Function Test, Pulmonary,Function Tests, Pulmonary,Pulmonary Function Test,Test, Pulmonary Function,Tests, Pulmonary Function,Function Test, Lung,Function Test, Respiratory,Function Tests, Lung,Function Tests, Respiratory,Lung Function Test,Respiratory Function Test,Test, Lung Function,Test, Respiratory Function,Tests, Lung Function,Tests, Respiratory Function
D002315 Cardiopulmonary Bypass Diversion of the flow of blood from the entrance of the right atrium directly to the aorta (or femoral artery) via an oxygenator thus bypassing both the heart and lungs. Heart-Lung Bypass,Bypass, Cardiopulmonary,Bypass, Heart-Lung,Bypasses, Cardiopulmonary,Bypasses, Heart-Lung,Cardiopulmonary Bypasses,Heart Lung Bypass,Heart-Lung Bypasses
D005260 Female Females
D006348 Cardiac Surgical Procedures Surgery performed on the heart. Cardiac Surgical Procedure,Heart Surgical Procedure,Heart Surgical Procedures,Procedure, Cardiac Surgical,Procedure, Heart Surgical,Procedures, Cardiac Surgical,Procedures, Heart Surgical,Surgical Procedure, Cardiac,Surgical Procedure, Heart,Surgical Procedures, Cardiac,Surgical Procedures, Heart
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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