THE VALUE OF INTEGRATED PULMONARY INDEX IN ASSESSMENT OF POSTOPERATIVE PERIOD AFTER OFF-PUMP CORONARY ARTERY BYPASS GRAFTING

Abstract

Forty patients after elective off-pump coronary artery bypass grafting (OPCAB) were enrolled into a prospective observational study and monitored using SpO2, EtCO2, pulse rate and respiratory rate. In addition, the Integrated Pulmonary Index (IPI, CapnostreamTM 20p, Covidien) was registered prior tracheal extubation and at 2, 6, 12, and 18 hrs after extubation. The hemodynamics was monitored using continuous non-invasive cardiac index (esCCO, Nihon Kohden) and left ventricular ejection fraction (EF) before and after the intervention. The value of IPI registered during the respiratory support correlated with cardiac index (p = 0.04). In the subgroup of the patients with IPI below 8 at 2 hrs after extubation, we found lower ejection fraction (p = 0.007). In addition, the IPI value ≤ 9 was a predictor of complicated early postoperative period (AUC = 0,7; p = 0, 04). Thus, IPI reflects the hemodynamic status and the course of postoperative stay after OPCAB.

Keywords

• postoperative respiratory failure
• coronary artery bypass grafting
• monitoring