Effectiveness of Aggressive Intraoperative Pulmonary Recruitment Maneuver in Limiting Immediate Postoperative Pathological Atelectasis Immediately before Weaning from Cardiopulmonary Bypass

Abstract

Objective: To determine effectiveness of aggressive Intraoperative Pulmonary recruitment maneuver before weaning in limiting immediate postoperative pathological Atelectasis in patients with  coronary artery bypass surgery

Methods:This Retrospective analysis study was conducted in Heart and Vascular Institution, Kulsum International Hospital, Islamabad. This study was conducted from 12^th November 2019 to 12^th April 2023. All patients   with elective coronary artery bypass surgery fulfilling inclusion criteria were included. In group A (n=20) the recruitment maneuver was initiated before weaning from bypass while in group B, the protocol recruitment maneuver was not initiated. The immediate postoperative pathological atelectasis based on chest x-ray was compared between two groups. 

Results: In this study, 40 patients with mean age 55.7 ± 5.2 years were included. There were 15 (75.0%) males and 5 (25.0%) females in group A while in group B there were 17 (85.0%) males and 3 (15.0%) females. In group A, post-operative chest x-ray demonstrated one basilar angle obliteration consistent with atelectasis in 1 (5.0%) patient. In group B, 12 (60.0%) patients demonstrated more than three basilar angles obliteration. There were 4 (20.0%) patients each with four basilar angles obliteration and one angle obliteration.   

Conclusion: Initiation of aggressive intraoperative pulmonary recruitment maneuver before weaning from bypass prevents atelectasis than in patients in whom aggressive intraoperative pulmonary recruitment maneuver was not initiated.