Clinical Research Directory

This study will include adults over 18 years of age requiring on-pump coronary bypass surgery with at least one of the following respiratory risk factors: * BMI \> or = 30 Kg / m2 * Active or withdrawn smoking for less than 6 weeks * COPD documented by pulmonologist or respiratory function test (LVEF/ FVC \<0.7 not reversible after bronchodilator) * Restrictive ventilatory disorders, defined by a CPT less than 80% of normal * Chronic respiratory failure, defined by a PaO2, at rest, in ambient air, less than 70 mmHg * Age \> or = 75 years old exclusion criteria: Any patient meeting one of the following criteria will be excluded from the study: * Emergency surgery * Other operative procedure planned during the same intervention (for example vascular), apart from the saphenous sample * Aortic dissection * Preoperative renal failure with GFR \<30 mL / min / 1.73 m2 * Left heart failure with Ejection fraction \<30% * Pulmonary arterial hypertension\> 50 mmHg * Hepatic cytolysis with ALT or AST\> 2N * ASA score \> or = 4 * Coagulopathy * Anticoagulants or antiaggregants not stopped in time (according to usual protocols) or with poorly performed or unjustified relay * Chronic use of opioids or history of drug addiction * Progressive pregnancy or breastfeeding * Inability to understand protocol and sign consent * Known allergy to one of the substances in the study protocol * Patients requiring assistance such as ECMO, intra-aortic counter pulsation balloon or Impella will be excluded from the protocol.