Incidence and Severity of Respiratory Insufficiency Detected by Transcutaneous Carbon Dioxide Monitoring After Cardiac Surgery and Intensive Care Unit Discharge

Abstract

Patients undergoing coronary artery bypass surgery and/or heart valve surgery using a median sternotomy approach coupled with the use of cardiopulmonary bypass often experience pulmonary complications in the postoperative period. These patients are initially monitored in an intensive care unit (ICU) but after discharge from this unit to the ward they may still have compromised pulmonary function. This dysfunction may progress to significant respiratory failure that will cause the patient to return to the ICU. To investigate the severity and incidence of respiratory insufficiency once the patient has been discharged from the ICU to the ward, this study used transcutaneous carbon dioxide monitoring to determine the incidence of unrecognized inadequate ventilation in 39 patients undergoing the current standard of care. The incidence and severity of hypercarbia, hypoxia, and tachycardia in post-cardiac surgery patients during the first 24 hours after ICU discharge were found to be high, with severe episodes of each found in 38%, 79%, and 44% of patients, respectively.