Alcántara-Noguez C, García-Lemus N, Bolio-Cerdán A, Ruíz-González S, Romero-Cárdenas P

Language: English
References: 10
Page: 70-74
PDF size: 134.62 Kb.

ABSTRACT

Background. Due to phrenic nerve injury after cardiac surgery diaphragmatic paralysis is a serious respiratory complication and leads to a longer hospital stay and even death. They display respiratory distress and delayed extubation. The diagnosis is carried out with a chest X-ray and confirmed with diaphragmatic mobility by fluoroscopy or ultrasound. Objective. To analyze the frequency of diaphragmatic paralysis (DP) in patients with a cardiac surgery history and to evaluate the clinical evolution and treatment. Material. A descriptive, retrospective, observational study of patients with a diagnosis of DP following cardiac surgery from January 2000 to December 2015 was performed. Results. A total of 4,154 heart surgeries were performed, with 39 cases (0.96%) of DP confirmed by fluoroscopy. The most affected groups have been infants with 59%, and weight less than 10 kg with 64%. Concerning the type of heart disease underwent surgery, those with univentricular physiology were the most frequent ones (33%). The most frequent palliative surgeries associated with DP were Blalock-Taussig shunt (35%). The most affected side was the right one (56.4%). Diaphragm plication was performed in 25 patients by thoracoscopy in 84% of them. Conclusions. DP is a rare complication after cardiac surgery, which should be suspected when respiratory support cannot be decreased, with no cardiac or pulmonary cause to justify it. Complications such as recurrent respiratory infections or ventilatory troubles may occur. Early diagnosis and treatment would cut down the number of complications as well as the in-hospital stay and economic costs.

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