Postperfusion lung syndrome like picture appeared in 17, (12 per cent), of 142 open heart patients analyzed in this study. The operations performed were mainly aortocoronary bypass grafts, valve replacements, and ventricular aneurysmectomy. All the 125 patients who did not develop the syndrome were used as controls. Six of the 17 patients, 35 per cent, who developed the acute respiratory syndrome had been in overt congestive heart failure during the preoperative period. In the control group, 12 patients, 9 per cent, had congestive heart failure prior to operation. Three episodes of shock, 28 per cent were observed in the study group immediately after surgery. The cardiac output was low in 11 out of 14 studies, there was high arteriovenous oxygen difference in 15, and there was a central venous pressure higher than 12 cm. of water in all. Nine patients out of the 17 patients with the acute respiratory syndrome died between three to ten days after surgery. Left ventricular failure, determined by the low cardiac output, low blood pressure, high central venous pressure, and high arteriovenous oxygen difference, was the only common factor found in most of our patients with the acute respiratory syndrome. These results led us to consider that the left ventricular failure would be the triggering mechanism for the development of postperfusion lung syndrome like picture.
|Number of pages
|New York State Journal of Medicine
|Published - 1976