Predictors of Prolonged Mechanical Ventilation in Adults After Acute Type-A Aortic Dissection Repair—Implications for the Future

Clendenen, Nathan; Weitzel, Nathaen

doi:10.1053/j.jvca.2017.05.022

Cited by 5 publications

(6 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is estimated that PMV patients with AAAD were prolonged by ve days both in hospital and ICU LOS. Similar conclusions have been con rmed in several other studies [10][11][12]. It is well-known that hospitalization costs increased gradually with the increase of hospitalization days, and the relationship between costs and LOS has been con rmed in many studies.…”

Section: Discussionsupporting

confidence: 87%

“…It can be seen that even in developed countries such as the United States, PMV has imposed a heavy economic burden on patients. Studies have shown that the incidence of PMV in AAAD patients is 28.9%-44.5% [10][11][12]. It is higher than other cardiac surgery patients [13][14].…”

Section: Introductionmentioning

confidence: 94%

“…However, there is no standardized de nition of delayed extubation following AAAD surgery. Therefore, we adopted this current de nition according to previously conducted studies [10][11][12].…”

Section: Data Collection and De Nitionsmentioning

confidence: 99%

See 2 more Smart Citations

Evaluating the Direct Economic Burden of Prolonged Mechanical Ventilation Among Patients With Acute Type A Aortic Dissection: a Propensity Score-matched Cohort Analysis

Zhang

Peng

Lin

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Prolonged mechanical ventilation (PMV) among acute type A aortic dissection (AAAD) may affect the prognosis, but poorly known about the direct economic burden of PMV in patients with AAAD. The present study was contributing to filling this knowledge gap.Methods: This present study was a retrospective cohort study. Age, gender, payment methods, and postoperative complications were matched at a 1:1 ratio by using a propensity score analysis of AAAD patients. The direct economic burden was expressed as the median 1:1 differences of various hospital costs and length of stay (LOS). The Wilcoxon signed-rank tests were used to compare the difference of direct economic burden at mechanical ventilation (MV) and PMV patients.Results: A total of 464 patients, PMV occurred in 142(30.6%) patients, and 218 patients were enrolled in the matched analysis. The estimated total direct economic burden of PMV was $4970.28(P<0.05). Among different hospital costs, western medicine ($3183.23) accounted for the highest category in the economic burden, followed by blood transfusion ($250.81) and materials fees ($207.43). The median hospital and Intensive Care Unit LOS in PMV groups were prolonged 5 days than those in MV groups (P < 0.05).Conclusions: Postoperative PMV was associated with increased economic burden among AAAD patients. This study emphasizes the need for early detection and management of PMV to reduce the economic burden.

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 94%

See 1 more Smart Citation

Evaluating the Direct Economic Burden of Prolonged Mechanical Ventilation Among Patients With Acute Type A Aortic Dissection: a Propensity Score-matched Cohort Analysis

Zhang

Peng

Lin

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…The duration of mechanical ventilation is a key determinant of postoperative length of stay (LOS) in pediatric intensive care units. Some previous studies demonstrated that prolonged mechanical ventilation was associated with longer ICU LOS in adult patients after cardiac surgery [11,12]. Long postoperative mechanical ventilation is usually attributed to the presence of chest infection or a worsened condition of heart failure.…”

Section: Resultsmentioning

confidence: 99%

Risk factors associated with prolonged postoperative intensive care unit stay in total anomalous pulmonary venous connection

Huang

Tang

Yang

et al. 2022

Preprint

View full text Add to dashboard Cite

Objective Prolonged intensive care unit stay occupies medical resources and increases medical cost. The present study aimed to identify the risk factors associated with prolonged postoperative intensive care unit (ICU) stay in total anomalous pulmonary venous connection (TAPVC). Methods The medical records of 85 patients who underwent TAPVC correction surgery were retrospectively analyzed. Patients were divided into the prolonged stay group and the standard stay group. The prolonged stay group included all the patients exceeding the 75th percentile for duration of ICU stay, and the standard stay group included all the remaining patient. The effect of patient variables on the ICU stay duration was investigated using univariate analysis and logistic regression analysis. Results The median age of 85 patients was 41 (18–103) days, median weight was 3.80 (3.30–5.35) kg. According to the grouping criteria, the postoperative duration of ICU stay in prolonged stay group (n = 23) was 11–68 days and the postoperative duration of ICU stay in standard stay group (n = 62) was 2–10 days. Preoperative lower saturation of pulse oximetry (SpO2), intraoperative higher plasma lactate level and prolonged postoperative mechanical ventilation were independent risk factors for prolonged ICU stay in children with TAPVC. When the preoperative SpO2 was lower than 88.5%, the highest plasma lactate value was more than 4.15 mmol/L, and the postoperative mechanical ventilator duration was longer than 53.5 hours, the risk of prolonged ICU stay was increased. Young age, low body weight, subcardiac type, need for vasoactive drug support, emergency operation, long anesthesia time, low SpO2 after anesthesia induction, long cardiopulmonary bypass (CPB) time and aortic clamp time, high level lactate, low temperature and large volume of ultrafiltration during CPB, large amount chest drainage, large red blood cells (RBCs) and plasma transfusion, postoperative cardiac dysfunction might be associated with prolonged ICU stay. Conclusions Preoperative lower SpO2, intraoperative higher plasma lactate level and prolonged postoperative mechanical ventilation were independent risk factors for prolonged ICU stay in children with TAPVC. When the SpO2 was lower than 88.5%, the highest plasma lactate value was more than 4.15 mmol/L, and the postoperative mechanical ventilator duration was longer than 53.5 hours, the risk of prolonged ICU stay was increased. Improved clinical management including early diagnosis and timely surgical intervention to reduce hypoxia time, intraoperative cardiac function protection, etc. can help to reduce ICU stay time.

show abstract

“…The duration of mechanical ventilation is a key determinant of the postoperative length of stay (LOS) in pediatric intensive care units. Previous studies have demonstrated that prolonged mechanical ventilation is associated with longer ICU LOS in adult patients after cardiac surgery [ 12 , 13 ]. Long postoperative mechanical ventilation is usually attributed to the presence of chest infection or worsened heart failure.…”

Section: Discussionmentioning

confidence: 99%

Risk factors associated with prolonged intensive care unit stay following surgery for total anomalous pulmonary venous connection: a retrospective study

Huang,

Tang,

Fan

et al. 2023

J Cardiothorac Surg

View full text Add to dashboard Cite

Background Prolonged intensive care unit (ICU) stays consume medical resources and increase medical costs. This study identified risk factors associated with prolonged postoperative intensive care unit (ICU) stay in children with total anomalous pulmonary venous connection (TAPVC). Methods The medical records of 85 patients who underwent surgical repair of TAPVC were retrospectively analyzed. The patients were divided into prolonged-stay and standard-stay groups. The prolonged stay group included all patients who exceeded the 75th percentile of the ICU stay duration, and the standard stay group included all remaining patients. The effects of patient variables on ICU stay duration were investigated using univariate and logistic regression analyses. Results Patient median age was 41 (18–103) days, and median weight was 3.80 (3.30–5.35) kg.Postoperative duration of ICU stay was 11–68 days in the prolonged stay group (n = 23) and 2–10 days in the standard stay group (n = 62). Lower preoperative pulse oximetry saturation (SpO2), higher intraoperative plasma lactate levels, and prolonged postoperative mechanical ventilation were independent risk factors for prolonged ICU stay. Preoperative SpO2 < 88.5%, highest plasma lactate value > 4.15 mmol/L, and postoperative mechanical ventilation duration was longer than 53.5 h, were associated with increased risk of prolonged ICU stay. Young age, low body weight, subcardiac type, need for vasoactive drug support, emergency surgery, long anesthesia time, low SpO2 after anesthesia induction, long cardiopulmonary bypass (CPB) and aortic clamp times, high lactate level, low temperature, large volume of ultrafiltration during CPB, large amounts of chest drainage, large red blood cells (RBCs) and plasma transfusion, and postoperative cardiac dysfunction may be associated with prolonged ICU stay. Conclusions Lower preoperative SpO2, higher intraoperative plasma lactate levels, and prolonged postoperative mechanical ventilation were independent risk factors for prolonged ICU stay in children with TAPVC. When SpO2 was lower than 88.5%, the highest plasma lactate value was more than 4.15 mmol/L, and the postoperative mechanical ventilator duration was longer than 53.5 h, the risk of prolonged ICU stay increased. Improved clinical management, including early diagnosis and timely surgical intervention to reduce hypoxia time and protect intraoperative cardiac function, may reduce ICU stay time.

show abstract

Predictors of Prolonged Mechanical Ventilation in Adults After Acute Type-A Aortic Dissection Repair—Implications for the Future

Cited by 5 publications

References 20 publications

Evaluating the Direct Economic Burden of Prolonged Mechanical Ventilation Among Patients With Acute Type A Aortic Dissection: a Propensity Score-matched Cohort Analysis

Evaluating the Direct Economic Burden of Prolonged Mechanical Ventilation Among Patients With Acute Type A Aortic Dissection: a Propensity Score-matched Cohort Analysis

Risk factors associated with prolonged postoperative intensive care unit stay in total anomalous pulmonary venous connection

Risk factors associated with prolonged intensive care unit stay following surgery for total anomalous pulmonary venous connection: a retrospective study

Contact Info

Product

Resources

About