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Khirurgii

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Year 2008 Vol. 16 No 2

LECTURES, REVIEWS

SPRINDZUK Ì.V., ADZERIKHO I.E., LAPTEVA I.M., DERGACHEV A.V.

BRONCHOPULMONARY COMPLICATIONS IN THE CARDIOSURGERY

The definition, incidence, risk factors, and some aspects of prophylaxis and treatment of bropnchopulmonary complications after cardiac surgery are reported in the article review. Postoperative pneumonias and pulmonary embolism are described in details.
Bronchopulmonary disorders and acute cardiac failure are the leading causes of post-operative morbidity and mortality after the cardiac surgery. The most common respiratory complications during the post-operative period are atelectases, pleural effusions, diaphragmatic dysfunction, and pneumonias. Plastic bronchitis is relatively rare but extremely dangerous specific complication after the hemodynamic correction surgeries. Bronchoscopic removal of casts, pulmonary artery stenting, baffle fenestration, urokinase aerosol, tissue plasminogen activator factor, mucolytics, sildenafil, bosentan and physiotherapy are used for the treatment of this complication.
Pneumonia incidence after the coronary artery bypass grafting and the valve surgery varies from 2% to 22%. The incidence of pulmonary embolism after cardiac surgery varies from 0,3% to 9,5%. Prevention and treatment of these complications seems to be possible when applying a complex approach, directed to risk factor reduction and prompt treatment of the diseases in the preoperative period.

Keywords: respiratory complications, bronchopulmonary complications, pneumonia, pulmonary embolism, prevention of surgical infections.
p. 149 – 157 of the original issue
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