Infant thoracic surgery: Procedure-dependent pulmonary response

Respiratory insufficiency is a common complication of thoracic surgery in infants. To better define this dysfunction, pulmonary compliance (CL) and resistance (R) were measured for 17 infants who underwent common thoracic procedures: Blalock-Taussig shunting (n = 7) repair of congenital coarctation of the aorta (n = 10). Measurements were obtained preoperatively and 0, 1, and 3 days postoperatively. Preoperatively, C(L) was lower and R was similar for the two groups. Both groups had decreased C(L) and increased R on postoperative day 0; infants with coarctation had recovery to preoperative values by postoperative day 1 for C(L), and day 3 for R. C(L) and R did not return to the preoperative values by postoperative day 3 in infants with a shunt procedure. The changes in R were greater than those in C(L) for both groups in the postoperative period. These data indicate that such thoracic procedures are associated with pulmonary morbidity that is airway- predominant, and that the degree of compromise and the time until recovery are, in part, procedure-specific.