• Dmitry Ponomarev, Oksana Kamenskaya, Asya Klinkova, Irina Loginova, Vladimir Lomivorotov, Igor Kornilov, Vladimir Shmyrev, Aleksander Chernavskiy, Giovanni Landoni, and Aleksander Karaskov.
• Department of Anesthesia and Intensive Care, Academician EN Meshalkin Novosibirsk State Budget Research Institute of Circulation Pathology, Novosibirsk, Russia. Electronic address: d_ponomarev@meshalkin.ru.
• J. Cardiothorac. Vasc. Anesth. 2017 Dec 1; 31 (6): 2010-2016.

ObjectiveTo investigate the prevalence and impact of abnormal respiratory patterns in cardiac surgery patients.DesignProspective cohort study.SettingTertiary hospital.ParticipantsPatients scheduled for elective coronary artery bypass graft surgery.InterventionsNone.Measurements And Main ResultsPulmonary function tests were performed in 454 patients before surgery. Abnormal respiratory patterns were defined as follows: obstructive (forced expiratory volume in 1 s [FEV1]/forced vital capacity [FVC]<0.70), restrictive (FEV1/FVC≥0.70 and FVC<80% of predicted), and mixed (FEV1/FVC<0.70 and both FEV1 and FVC<80% of predicted). Of the 31 patients with a history of chronic obstructive pulmonary disease, no abnormal respiratory pattern was confirmed in 5. Of the 423 patients without a history of lung disease, the authors newly identified 57 obstructive, 46 restrictive, and 4 mixed patterns. Therefore, lung disease was reclassified in 24.7% of cases. Independent predictors of obstructive pattern were age, male sex, history of smoking, and chronic obstructive pulmonary disease. Obstructive lung disease was associated with 16 hours or longer ventilation. A reduced FEV1 was associated with a likelihood of atrial fibrillation (1-L decrement, odds ratio: 1.38, 95% confidence interval: 1.01-to-1.90, p = 0.04) and hospitalization time (regression coefficient: 1.23, 95% confidence interval: 0.54-to-1.91, p<0.001).ConclusionsAbnormal respiratory patterns are common and often underdiagnosed in the cardiac surgery setting. Pulmonary function tests help reveal patients at risk of complications and may provide an opportunity for intervention.Copyright © 2016 Elsevier Inc. All rights reserved.

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