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

Methodology: This retrospective analysis was conducted at Heart and Vascular Institution, Kulsum International Hospital, Islamabad from November 2019 to 12th April 2023. All patients   with elective coronary artery bypass surgery 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.