Aug 19, 2009 - Objective: Acute respiratory dysfunction (ARD) can occur after acute type A aortic dissection, but relatively little is known about ARD in such.
European Journal of Cardio-thoracic Surgery 37 (2010) 691—696 www.elsevier.com/locate/ejcts
Acute respiratory dysfunction after surgery for acute type A aortic dissection Evaldas Girdauskas a,*, Thomas Kuntze a, Michael Andrew Borger a, Knut Ro ¨hrich a, Dierk Schmitt a, Jens Fassl b, Volkmar Falk a, Friedrich-Wilhelm Mohr a a
Department of Cardiac Surgery, Heart Center Leipzig, Stru ¨ mpellstrasse 39, 04289 Leipzig, Germany Department of Anesthesiology, Heart Center Leipzig, Stru ¨mpellstrasse 39, 04289 Leipzig, Germany
b
Received 30 December 2008; received in revised form 10 July 2009; accepted 15 July 2009; Available online 19 August 2009
Abstract Objective: Acute respiratory dysfunction (ARD) can occur after acute type A aortic dissection, but relatively little is known about ARD in such patients. This study aims to analyse the clinical impact of ARD after surgery for acute type A aortic dissection and to assess possible treatment options. Methods: We reviewed our institutional database to identify patients who underwent surgery for acute type A dissection between October 1994 and January 2008 (n = 276). Postoperative ARD was defined as oxygenation impairment (PaO2/FiO2 100 mmHg. Patients were extubated when they had adequate gas exchange (PaO2 >80 mmHg with FiO2 of 0.40 or less), were haemodynamically stable, normothermic and did not have significant bleeding (0.5 ml kg 1 h 1) and a pulmonary capillary wedge pressure below 18 mmHg. Haemoglobin concentration
