Chest Complications : Many of the patients undergoing coronary artery bypass surgery have risk factors for post-operative lung complications. These include old age, chronic obstructive pulmonary disease (COPD) and heavy smoking with reduced pulmonary functions. So it is important to prevent and treat lung complications in the early post-operative period.
After CABG, patients are ventilated for a few hours or overnight. Patients should have stopped smoking from the time of first consultation for ischaemic hea1-t disease. Pulmonary function tests and pre-operative physiotherapy are done in patients who are at risk. All patients are taught deep breathing and coughing by a physiotherapist pre-operatively. While patient is on ventilator, effective suction to clear all secretions, intermittent laudatory ventilation (IMV) and periodic sighs to prevent alveolar collapse help in reducing pulmonary complications. After extubation, if required, intermittent positive pressure ventilation (IPPV) with a mask will reduce chances or alveolar collapse. Alvcolm collapse lends to intra pulmonary right to left shunt and fall in PO. Regular physiotherapy, coughing, deep breathing and nebulisation with bronc60 dilators will be helpful for early recovery. If collapse of segments of lung occurs; fibre optic bronchoscopy should be done. Very few patients might require prolonged ventilation after tracheostomy.