Effect of preemptive bronchodilator therapy in reducing postoperative pulmonary complications in smokers undergoing CABG.

Abstract

Objective: To study the effect of preemptive bronchodilator therapy in reducing postoperative pulmonary complications in smokers undergoing coronary artery bypass grafting. Study Design: Randomized Control Trial. Setting: Army Cardiac Centre CMH Lahore. Period: January to June 2021. Material & Methods: A total of 200 patients undergoing CABG in Army cardiac Centre CMH Lahore were included in this study. Patients were divided in to two groups i.e. case and interventional groups. All the procedures were performed by the consultant cardiac surgeon of experience of more than 5 years. In interventional group patients were administered with bronchodilator therapy i.e. salmicort inhaler preoperatively along with other necessary preoperative measures while in case group no bronchodilator therapy was introduced. Preoperatively, ASA status, FEV1, BMI, oxygen saturation, Ejection fraction (EF), and smoking status, COPD diagnosis, and PaCO₂, FVC-L, PEFR, Hb and CRP levels was assessed. Postoperatively, different pulmonary function tests were performed in both groups i.e. need for prolonged oxygen therapy, prolonged ICU stay, re-intubation and antibiotic use. Results: The frequencies of prolonged oxygen therapy and ICU stay, re-intubation, antibiotics use, COPD diagnosis were same in both the groups. Therefore, the differences were statistically insignificant. But, PaCO₂, in intervention group was higher than the control group with significant difference, (p=0.004). Conclusion: It can be concluded from the results of this study that administration of bronchodilator therapy preoperatively in patients with known history of smoking undergoing coronary artery bypass graft surgery has no significant effect in terms of outcome variables.