Background It is controversial whether pulmonary function
testing should be performed routinely in cardiac surgery patients. The
aim of our study was to focus on patients who have congestive heart
failure, caused by left ventricular dysfunction or left-sided heart
valve disease, and study the prognostic value of performing preoperative
pulmonary function testing on their postoperative outcomes
Methods: This is a retrospective propensity score matched study
that included 366 patients with congestive heart failure who underwent
cardiac surgery and had preoperative pulmonary function test. The
patients were divided into two groups: Group 1; who had a normal or mild
reduction in pulmonary function tests and group 2; who had moderate to
severe reduction in pulmonary function tests. The postoperative
outcomes, including pulmonary complications, were compared between the
two groups. Results Pulmonary function tests were normal or
mildly reduced in 190 patients (group 1) and moderately to severely
reduced in 176 patients (group 2). Propensity matching identified 111
matched pairs in each group with balanced preoperative and operative
characteristics. Compared to group 1, Group 2 had longer duration of
mechanical ventilation [12 (7.5- 16) vs. 9 (6.5- 13) hours,
p<0.001], higher postoperative Creatinine [111 (90- 142)
vs. 105 (81- 128) µmol/dl, p=0.02] and higher hospital mortality
(6.31% vs 0%, p=0.02). Conclusion In congestive heart failure
patients undergoing cardiac surgery, moderate to severe reduction of
pulmonary function test was associated with longer duration of
mechanical ventilation and higher hospital mortality.
Should Routine Pulmonary Function Tests be Performed in Patients with Left Ventricular Dysfunction and/or Congestive Heart Failure undergoing Cardiac Surgery?
