Lung ventilation in minimal invasive direct coronary artery bypass surgery

Background. Providing oxygenating lung function is a difficult task during minimal invasive direct coronary artery bypass surgery (MIDCAB).

The objective was to study the possibility of using high-frequency jet ventilation (HFJV) of an independent lung during MIDCAB operations.

Materials and methods. 69 patients were examined. Single-lung ventilation (SLV) was performed in 32 patients, and differentiated SLV with HFJV of an independent lung was performed in 37 patients. The gas composition of arterial blood, parameters of artificial ventilation and metabolic markers were analyzed. The nature and frequency of postoperative complications were assessed.

Results. In the SLV+HFJV group, compared with the SLV group, the level of oxygen tension in arterial blood (PaO₂) and the PaO₂/FiO₂ ratio were higher at all stages of SLV. The number of patients with PaO₂/FiO₂ ≤200 in the OVL group compared to the OVL+HFV group was higher at the same stages. No difference was found between the groups in the number of postoperative complications, duration of artificial lung ventilation (ALV), and stay in the intensive care unit (ICU).

Conclusions. The use of differentiated OVL with HFJV of an independent lung in MIDCAB operations allows for better oxygenating function of the lungs, prevents the development of hypoxemia, and does not lead to an increase in the number of postoperative complications.

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