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European Heart Journal 1989 10(Supplement H):17-21; doi:10.1093/eurheartj/10.suppl_H.17
Copyright © 1989 by the European Society of Cardiology.
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© 1989 The European Society of Cardiology

Pulmonary shunting after cardiopulmonary bypass

H. H. M. Korsten*,, J. A. Leusink{dagger}, J. Spierdijk{ddagger}, J. H. Meijer||, J. E. W. Beneken and W. G. Zijlstra§

Department of Anesthesiology, State University Groningen, The Netherlands
* Catharina Hospital, Eindhoven, State University Groningen, The Netherlands
{dagger} Antonius Hospital, Nieuwegein, State University Groningen, The Netherlands
{ddagger} University Hospital, Leiden, State University Groningen, The Netherlands
|| Department of Medical Physics, Free University, Amsterdam, State University Groningen, The Netherlands
Division of Medical Electric Engineering, Eindhoven University of Technology, State University Groningen, The Netherlands
§ Department of Physiology, State University Groningen, The Netherlands

Reprint requests to: Dr H. H. M. Korsten, Department of Anesthesiology, Catharina Hospital, Michelangelolaan 2, Postbus 1350, 5602 ZA Eindhoven, The Netherlands

The effect of cardiopulmonary bypass (CPB) on pulmonary function was investigated in 32 adult patients, including 23 patients undergoing coronary artery bypass grafting and nine patients undergoing heart-valve replacement. Clinical indicators for pulmonary insufficiency, such as chest X-ray, gas exchange and lung function tests were measured. Transthoracic electrical impedances were measured, and the mean specific thoracic impedance (RHO) was calculated. (RHO is an accurate indicator for the intrathoracic fluid content; low RHO values correspond with high intrathoracic fluid content.) Significant postoperative decreases in RHO were paralleled by a significant impairment of gas exchange. Chest X-rays demonstrated accumulation of intrathoracic fluid. Lung function tests showed significant postoperative decreases in lung volumes and vital capacity. These findings are consistent with the concept that CPB provokes an inflammatory reaction in the lung. The non-invasive RHO meaurement proved to be simple and in good agreement with clinical indicators. This method may be a real asset in the prevention and treatment of pulmonary dysfunction after CPB. The possibility of calibrating RHO with respect to absolute values of intrathoracic fluid content should.

Key Words: Extracorporeal circulation • heart surgery • impedance • transthoracic • pulmonary oedema • pulmonary gas exchange


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