Die kardiorespiratorische Polygraphie zur Differentialdiagnostik der respiratorischen Insuffizienz bei Patienten nach koronarer Bypass-Operation

Background: In intensive care medicine it is well established how to diagnose respiratory insufficiency caused by cardiopulmonary diseases. However, there is no consensus how to diagnose respiratory insufficiency which may be caused by extrapulmonary disturbances of the respiratory apparatus. Patients and Methods: In 5 patients we performed postoperatively a cardio-respiratory polygraphy for 12 to 13 hours using Polymesam®. This unit allows to record airflow, respiratory movements of the chest and abdomen, arterial oxygen saturation, heartrate, body position and EKG. Results: The present case-series-study demonstrates that patients after arterio-coronary bypass surgery may present respiratory insufficiency caused by extrapulmonary disturbances of the respiratory apparatus (central and obstructive apnea and hypopnea). The respiratory insufficiency occurs during nighttime even when supplemented oxygen (2 to 3 1/min) is delivered. Conclusion: We conclude that the cardiopulmonary polygraphy for assessing respiratory insufficiency in patients after coronary bypass surgery is important, in order to avoid severe arterial hypoxemia which may produce cardiovascular instability in these patients.