PT  - JOURNAL ARTICLE
AU  - Ana Sofia Santos
AU  - Ricardo Coelho
AU  - Raquel Rosa
AU  - Alexandra Borba
AU  - José Fragata
AU  - João Cardoso
TI  - Pulmonary function criteria in pre-operative evaluation for cardiac surgery
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P3950
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P3950.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P3950.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - Preoperative pulmonary function (PF) testing is often indicated in the evaluation of surgical candidates, especially if scheduled for thoracic and upper abdominal surgery.Patients (pts) submitted to non-resective thoracic surgery are traditionally considered high-risk if FEV1 < 1L (or <60% of predicted), FVC < 1,5L or DLco <60% of predicted.Yet, more recent publications suggest that these limits may be too conservative and that surgery can be safely performed in selected high-risk pts.The aim of this study was to evaluate the importance of pre-operative lung dysfunction in the outcome of pts submitted to cardiac surgery (particularly length of mechanical ventilation (MV)).Methods: Pts included in this study were pts evaluated for cardiac surgery (CABG and/or valvular) at our PF Laboratory. The variables evaluated were demographics, PF results and surgical variables and the differences between pts with or without lung dysfunction were analysed.Results: Thirty pts were studied (60% male, mean age 69y, 36,6% never smokers). Changes in PF were present in 70% of pts and 43,3% were high risk pts. The mean EuroSCORE II was 4,66% and 50% of pts underwent valve surgery, 33.3% CABG and 16.7% both procedures. Extracorporeal circulation was used in 83,3% of pts. Only 1 pt died. No single pulmonary function change in high risk patients was associated with increased MV time but these pts had longer length of hospital stay (7,8 vs. 11,7 days).Conclusions: The results in this study suggest that the criteria used to define high risk pts for non-resective thoracic surgery may be too restrictive and that a less conservative approach can be used when evaluating surgical candidates with pulmonary dysfunction.