Eastern J Med. 2021; 26(1): 17-23 | DOI: 10.5505/ejm.2021.52386

The effect of positive pressure volume control mechanical ventilation on arterial stiffness measured by carotid-femoral (aortic) pulse wave velocity in patients who operated for coronary artery bypass surgery

Pýnar Kolusarý¹, Kamil Karaoðlu², Mustafa Yýldýz^3
1Department Of Anesthesiology And Reanimation, Van Education and Research Hospital, Van, Turkey
²Department Of Anesthesiology And Reanimation, Istanbul University Cardiology Institute, Istanbul, Turkey
³Department Of Cardiology, Istanbul University Cardiology Institute, Istanbul, Turkey

INTRODUCTION: Coronary artery bypass surgery is the most commonly performed heart surgery. After operation, at a certain time, patients are followed in mechanical ventilator support at intensive care units. Pulse wave velocity (PWV) is one of the most important parameters to evaluate elastic properties of great arteries. Increased values of PWV is an indicator of diffuse atherosclerosis. Mechanical ventilation induces cyclic changes in vena cava blood flow, pulmonary artery blood flow and aortic blood flow. In this context, respiratory changes in aortic blood flow are reflected by swings in blood pressure. In this study, the effect of mechanical ventilation on arterial stiffness measured by carotid-femoral (aortic) PWV in patients who operated for coronary artery bypass surgery were investigated.
METHODS: A total of 20 patients who are operated for coronary artery bypass surgery, followed at intensive care units and applied mechanical ventilation, were enrolled in this study. Aortic PWV measurements were performed twice, including preoperative and postoperative times, from patients. Aortic PWV was determined by using an automatic device, the Complior Colson (France),which allows online pulse wave recording and automatic calculation of PWV.
RESULTS: Preoperative measured systolic, diastolic and mean blood pressures, PWV values ​​higher than according to the values ​​measured postoperative (respectively p=0.014, p<0.001, p<0.001, p=0.001); PWV propagation time and heart rate (respectively p=0.033, p=0.006) values were higher at postoperative care.
DISCUSSION AND CONCLUSION: In our study, the effect of positive pressure volume control mechanical ventilation on the patients who operated for coronary artery bypass surgery was caused by a decrease in PWV.

Keywords: Arterial stiffness, Coronary artery bypass surgery, Positive pressure volume control mechanical ventilation, Pulse wave velocity

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