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Objectives: The aim of this study was to evaluate the effects of pleural integrity on respiratory system functions after cardiac surgery. Patients and methods: In this prospective, cohort study, a total of 114 patients (84 males, 30 females; mean age 56.3±13.1 years; range, 21 to 76 years) who underwent on-pump cardiac surgery between February 2016 and June 2016 were included. The patients were divided into two groups: open (Group 1, n=56) and intact pleura (Group 2, n=58). Arterial blood gas values (pH, partial pressure of oxygen [PaO2], partial pressure of carbon dioxide [PaCO2], and oxygen saturation [SaO2]), and respiratory and heart rates were evaluated per-operatively. Preoperative and the fifth postoperative day values of forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC% were compared between the groups. Results: Extubation time and duration of mechanical ventilation were similar in both groups (p>0.05). There was a significant decrease of FEV1 and FVC of open versus intact pleura group in terms of preoperative and the fifth postoperative day values (p<0.001 and p<0.001, respectively). There was no significant difference in the PaCO2 in arterial blood gas between the groups (open; 38.6±3.5 vs. 39.0±4.2 mmHg, Intact; 37.8±2.3 vs. 38.1±2.1 mmHg, respectively p=0.49) at room air before surgery and on the first postoperative day (p>0.05). However, a significant decrease was observed in the PaO2 (p=0.006 vs. p<0.001, respectively) and SpO2 (p<0.001 vs. p<0.001, respectively) values of the groups between the preoperative and the fifth postoperative day values. The only significant difference regarding postoperative complications, which was higher in Group 1 (p=0.003), was observed in bleeding on the first postoperative day. Conclusion: Based on our study findings, opened pleura seems not to be associated with a higher incidence of pulmonary complications, compared to the intact pleura.

Does pleurotomy have any effect on postoperative respiratory system functions after cardiac surgery?