• Surendra Kumar Jangid, Neeti Makhija, Sandeep Chauhan, and Sambhunath Das.
• Department of Cardiac Anaesthesia & Critical Care, Cardiothoracic Centre, CNC, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
• J. Cardiothorac. Vasc. Anesth. 2022 Oct 1; 36 (10): 3791-3799.

ObjectivesTo compare the changes in thoracic fluid content, PaO2/FIO2 ratio, plateau pressure, compliance, and postoperative ventilation duration in off-pump coronary artery bypass grafting (OPCAB) and on-pump coronary artery bypass grafting (ONCAB).DesignProspective observational study.SettingTertiary-care cardiac center.ParticipantsOver an 18-month period, from December 2019 to May 2021, 111 patients who underwent CAB grafting were enrolled. Group I constituted OPCAB patients and Group II the ONCAB patients.InterventionsAfter induction, the authors measured thoracic fluid content (TFC), pulmonary compliance, airway pressures, and the PaO2/FIO2 ratio before skin incision (T1) and after skin closure (T2). The input, output, as well as the duration of postoperative ventilation, also were recorded.ResultsAt T2, the ONCAB group had a significantly higher change in TFC than the OPCAB group (5.4 ± 1.86 kOhm-1v 4.32 ± 1.84 kOhm-1, p = 0.012). The fluid balance was significantly higher in the OPCAB group compared with the ONCAB group (2,159.21 ± 108.73 mL v 1,792.50 ± 151.88 mL, p = 0.0001). The decrease in PaO2/FIO2 ratio was significantly lower in the OPCAB group compared with the ONCAB group (-71.34 ± 23.42 v -123.65 ± 36.81, p = 0.000). The increase in plateau pressure, decrease in compliance, and postoperative ventilation period were significantly higher in the patients who underwent ONCAB than the patients who underwent OPCAB (p < 0.05).ConclusionThe change in TFC was greater in the ONCAB group, despite the fact that the fluid balance was higher in the OPCAB group. A higher TFC in ONCAB led to lower PaO2/FIO2 ratio, lower compliance, higher plateau pressures, and longer postoperative ventilation.Copyright © 2022 Elsevier Inc. All rights reserved.

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