Pro: Mechanical Ventilation Should Be Continued During Cardiopulmonary Bypass

POSTOPERATIVE PULMONARY dysfunction, a known complication after cardiac surgery, is associated with significant morbidity and mortality.

Pulmonary complications include hypoxemia; increased work of breathing; atelectasis; pneumonia; and in 2% to 5% of patients, more severe consequences, such as acute respiratory distress syndrome.
These are associated with high rates of prolonged hospital stay and perioperative mortality.2 The technique of cardiac surgery and its associated cohort of surgical patients are partially to blame for this increased risk.3 Even though the pathophysiology of such dysfunction is not well understood, it is believed to be due largely to the systemic effects of cardiopulmonary bypass (CPB).4 It is the authors’ opinion that the inflammatory and mechanical effects of CPB, particularly those responsible for pulmonary dysfunction, can be minimized by continuing mechanical ventilation during this time.