Early Extubation after Cardiac Surgery: a Prospective Clinical Trial Including Patients At Risk

Abstract

1. All patients are basically suitable for early extubation, with the presence of preoperative risk factors used in this study being poor predictors of prolonged ventilation. 2. The necessity of prolonged ventilation is primarily determined by intra- or perioperative complications.

Risk Factors for Hypoxemia After Surgery for Acute Type A Aortic Dissection

“…Several risk factors for acute respiratory distress syndrome (ARDS) have been reported in the context of coronary artery bypass grafting and valve surgery, including advanced age, 2-5 obesity, 3,4 smoking history, 6,7 previous heart surgery, 5,8 emergency surgery, [3][4][5][6][7] reduced cardiac function, [3][4][5][6] advanced chronic obstructive pulmonary disease, 7 excessive volume of blood transfusion, 1,8 and prolonged CPB time. 3,4 However, we were unable to find any reports limited to surgery for acute aortic dissection.…”

Cardiopulmonary Predicators of Dysfunctional Ventilator Weaning Response after Coronary Artery Bypass Graft

“…Many researchers have cited the need for studies to improve the criteria to predict early extubation and DVWR (36)(37)(38)(39)(40). Some researchers have examined the associated risk factors, readiness, feasibility, and effectiveness of early extubation (1,(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). Other researchers have focused on identifying the associated factors and complications of early extubation failure (2,(40)(41)(42)(43)(44)(45).…”

“…Clinical variables such as chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), emergency surgery, and number of grafts are found to be associated with DVWR and PMV (6,7,12,20,21,68). Some researchers reported that DVWR is associated with the adult respiratory distress syndrome after CABG surgery (6,16,24,58,(69)(70)(71) prophylaxis. Multiorgan dysfunction syndrome is also a complication associated with DVWR and PMV (29)(30)(31).…”

“…Cases were defined as patients who remained on mechanical ventilator more than 8 hours after CABG surgery (1,(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). Controls were defined as patients who were extubated within 8 hours after the CABG surgery (1,(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). Cases and controls were selected from the same hospital.…”

“…Most patients are extubated within 6 to 8 hours after surgery. However, 20% to 40% of patients remain intubated 12 hours after surgery due to dysfunctional ventilator weaning response (1,(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25).…”