Abstract:
OBJECTIVE:To study the incidence of phrenic neuropathy following coronary artery bypass grafting and determine long-term outcome. DESIGN:Prospective observational. SETTING:Surgical ICU in a university hospital, out-patient follow-up. PATIENTS:Ninety-two consecutive patients undergoing open heart surgery. INTERVENTIONS:None. MEASUREMENTS:Chest radiographs (CXR) 48 to 72 h post-operatively, ultrasonography of diaphragm, phrenic nerve conduction studies, diaphragmatic electromyogram, each repeated every 1 to 3 months until normal. MAIN RESULTS:Seventy-eight of 92 (78 percent) patients had abnormal radiographs, 42 of 78 (54 percent) with abnormal CXRs had abnormal diaphragm motion, 24 of 42 (57 percent) with abnormal motion had phrenic neuropathy. Patients with normal diaphragm motion improved faster than those without; patients with normal nerve conduction (and abnormal motion) improved faster than those with abnormal nerve conduction. CONCLUSIONS:Phrenic neuropathy is relatively common if sensitive tests are utilized for diagnosis. Nerve conduction studies can predict duration of morbidity. Most patients have low morbidity and recover fully. Abnormal diaphragm motion alone is not diagnostic of phrenic nerve injury.
journal_name
Chestjournal_title
Chestauthors
DeVita MA,Robinson LR,Rehder J,Hattler B,Cohen Cdoi
10.1378/chest.103.3.850subject
Has Abstractpub_date
1993-03-01 00:00:00pages
850-6issue
3eissn
0012-3692issn
1931-3543pii
S0012-3692(15)41622-8journal_volume
103pub_type
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