Electrophysiological evaluation of phrenic nerve injury during cardiac surgery – a prospective, controlled, clinical studyReport as inadecuate




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BMC Surgery

, 4:2

First Online: 14 January 2004Received: 23 August 2003Accepted: 14 January 2004

Abstract

BackgroundAccording to some reports, left hemidiaphragmatic paralysis due to phrenic nerve injury may occur following cardiac surgery. The purpose of this study was to document the effects on phrenic nerve injury of whole body hypothermia, use of ice-slush around the heart and mammary artery harvesting.

MethodsElectrophysiology of phrenic nerves was studied bilaterally in 78 subjects before and three weeks after cardiac or peripheral vascular surgery. In 49 patients, coronary artery bypass grafting CABG and heart valve replacement with moderate hypothermic mean 28°C cardiopulmonary bypass CPB were performed. In the other 29, CABG with beating heart was performed, or, in several cases, peripheral vascular surgery with normothermia.

ResultsIn all patients, measurements of bilateral phrenic nerve function were within normal limits before surgery. Three weeks after surgery, left phrenic nerve function was absent in five patients in the CPB and hypothermia group 3 in CABG and 2 in valve replacement. No phrenic nerve dysfunction was observed after surgery in the CABG with beating heart no CPB or the peripheral vascular groups. Except in the five patients with left phrenic nerve paralysis, mean phrenic nerve conduction latency time ms and amplitude mV did not differ statistically before and after surgery in either group p > 0.05.

ConclusionsOur results indicate that CPB with hypothermia and local ice-slush application around the heart play a role in phrenic nerve injury following cardiac surgery. Furthermore, phrenic nerve injury during cardiac surgery occurred in 10.2 % of our patients CABG with CPB plus valve surgery.

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Author: Suat Canbaz - Nilda Turgut - Umit Halici - Kemal Balci - Turan Ege - Enver Duran

Source: https://link.springer.com/article/10.1186/1471-2482-4-2







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