The Cost of Respiratory Effort in Postoperative Cardiac Patients
1963; Lippincott Williams & Wilkins; Volume: 28; Issue: 4 Linguagem: Inglês
10.1161/01.cir.28.4.552
ISSN1524-4539
AutoresNalda Thung, P. Herzog, IGNACIO I. CHRISTLIEB, Webb M. Thompson, John F. Dammann,
Tópico(s)Hemodynamic Monitoring and Therapy
ResumoHomeCirculationVol. 28, No. 4The Cost of Respiratory Effort in Postoperative Cardiac Patients Free AccessResearch ArticlePDF/EPUBAboutView PDFSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessResearch ArticlePDF/EPUBThe Cost of Respiratory Effort in Postoperative Cardiac Patients NALDA THUNG, P. HERZOG, IGNACIO I. CHRISTLIEB, W. M. THOMPSONJR. and J. FRANCIS DAMMANNJR. NALDA THUNGNALDA THUNG From the Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, and Karolinska Institute, Stockholm, Sweden. , P. HERZOGP. HERZOG From the Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, and Karolinska Institute, Stockholm, Sweden. , IGNACIO I. CHRISTLIEBIGNACIO I. CHRISTLIEB From the Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, and Karolinska Institute, Stockholm, Sweden. , W. M. THOMPSONJR.W. M. THOMPSONJR. From the Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, and Karolinska Institute, Stockholm, Sweden. and J. FRANCIS DAMMANNJR.J. FRANCIS DAMMANNJR. From the Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, and Karolinska Institute, Stockholm, Sweden. Originally published1 Oct 1963https://doi.org/10.1161/01.CIR.28.4.552Circulation. 1963;28:552–559AbstractThe Engstrom volume-controlled respirator is used routinely in patients after open-heart surgery as a short-term prophylaxis to avoid hypoxia, respiratory acidosis, and excessive fatigue. The respirator should be discontinued when pulmonary function is improved sufficiently to the point where the work of breathing is no longer excessive. With a spirometer designed for the Engstrom respirator, we have determined oxygen consumption and cardiac output in the spontaneously breathing patient and while assisted by the respirator. The difference between the two measurements reflects the oxygen cost of breathing and thus the work that can be spared the heart, by proper mechanical ventilation, during the period of acute postoperative stress. We have demonstrated that the work of breathing, even in good risk patients, is appreciably increased postoperatively, that it is maximal immediately and then falls. These data lend objective support for the prophylactic use of respiratory assistance in patients after cardiac surgery. A similar application to other debilitated surgical and medical patients should be investigated. eLetters(0) eLetters should relate to an article recently published in the journal and are not a forum for providing unpublished data. Comments are reviewed for appropriate use of tone and language. Comments are not peer-reviewed. Acceptable comments are posted to the journal website only. Comments are not published in an issue and are not indexed in PubMed. Comments should be no longer than 500 words and will only be posted online. References are limited to 10. Authors of the article cited in the comment will be invited to reply, as appropriate. Comments and feedback on AHA/ASA Scientific Statements and Guidelines should be directed to the AHA/ASA Manuscript Oversight Committee via its Correspondence page. Sign In to Submit a Response to This Article Previous Back to top Next FiguresReferencesRelatedDetailsCited By Hanley C and Wijeysundera D (2021) Perioperative risk assessment – focus on functional capacity, Current Opinion in Anaesthesiology, 10.1097/ACO.0000000000000988, 34:3, (309-316), Online publication date: 1-Jun-2021. 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