НАРУШЕНИЯ ФУНКЦИИ ВНЕШНЕГО ДЫХАНИЯ И ИХ ВЛИЯНИЕ НА КЛИНИЧЕСКИЙ ИСХОД У КАРДИОХИРУРГИЧЕСКИХ ПАЦИЕНТОВ

Цель: изучить встречаемость и характеристики респираторных нарушений и их влияния на клиническое течение у пациентов при операциях коронарного шунтирования. Материал. В проспективное когортное исследование было включено 454 пациента, которым планировалось коронарное шунтирование. Оценку функции внешнего дыхания выполняли перед операцией. Патологический респираторный паттерн определяли на основании объема форсированного выдоха в 1-ю секунду (ОФВ1 ) и форсированной жизненной емкости легких (ФЖЕЛ). Критерием обструктивного паттерна являлось соотношение ОФВ1 /ФЖЕЛ < 0,70, рестриктивного − комбинация ОФВ1 /ФЖЕЛ ≥ 0,70 и ФЖЕЛ < 80% от «должного». Результаты. Обструктивный и рестриктивный паттерны были выявлены у 72 (15,8%) и 50 (11,0%) пациентов соответственно. Из 133 пациентов со снижением функции внешнего дыхания только 26 имели диагноз хронической обструктивной болезни легких. Бронхиальная обструкция была связана с риском развития фибрилляции предсердий, увеличением длительности искусственной вентиляции легких и срока госпитализации. Вывод. Продемонстрирована возможность улучшения клинических исходов у кардиохирургических пациентов путем диагностики респираторных нарушений, выявления групп риска и профилактики осложнений.

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