ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Investigation of respiratory muscle strength in patients with chronic obstructive pulmonary disease undergoing coronary artery bypass grafting surgery
Volkan Yarar1, Hasan Hepağuşlar1, Ayşe Pelin Girgin1, Tuğra Gençpınar2, Arif Hikmet Çımrın3, Eyüp Hazan2
1Dokuz Eylül Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, İzmir, Türkiye
2Dokuz Eylül Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, İzmir, Türkiye
3Dokuz Eylül Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, İzmir, Türkiye
DOI : 10.5606/tgkdc.dergisi.2012.157
Background: This study aims to investigate the effects of coronary artery bypass grafting (CABG) surgery on pulmonary function and respiratory muscle strength in patients with chronic obstructive pulmonary disease (COPD).

Methods: Sixty adult patients at >18 years of age undergoing CABG surgery under cardiopulmonary bypass with median sternotomy were assigned into two groups, including Control group (n=30) and COPD group (n=30). Preoperative and postoperative values of pulmonary function (FEV1, FVC) and respiratory muscle strength (Pimax, SNIP, PEmax) were obtained.

Results: Preoperative values of pulmonary function and respiratory muscle strength did not differ significantly between groups (p>0.05), except FEV1 value (p=0.00). The values of FEV1 (p=0.00, p=0.00, respectively), FVC (p=0.00, p=0.00, respectively), Pimax (p=0.00, p=0.00, respectively), SNIP (p=0.00, p=0.00, respectively) and PEmax (p=0.00, p=0.00, respectively) decreased postoperatively both in Control and COPD groups. No significant difference was found in the values of pulmonary function and respiratory muscle strength between the groups at the third postoperative day (p>0.05). The percentage decreases of the values of FEV1 (p=0.01) and FVC (p=0.02) within the control group were significantly higher than those of within the COPD group. No significant difference was found in the percentage decreases of intragroup respiratory muscle strength values between the groups (p>0.05).

Conclusion: While low preoperative FEV1 was obtained in patients with COPD, the values of FVC and respiratory muscle strength were similar in patients with and without COPD. The values of pulmonary function and respiratory muscle strength decreased as a result of the surgical procedure in all patients. The values of FEV1 and FVC decreased more in patients without coexisting pulmonary disease compared to patients with COPD. However, the presence of COPD did not affect the preoperative respiratory muscle strength values and the changes in these values caused by surgery.

Keywords : Cardiopulmonary bypass, chronic obstructive pulmonary disease, pulmonary function test, respiratory muscle strength test
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