Predictors of prolonged mechanical ventilation in a cohort of 5123 cardiac surgical patients

Cislaghi, F.; Condemi, A. M.; Corona, Alberto

doi:10.1097/eja.0b013e3283232c69

Cited by 122 publications

(145 citation statements)

References 29 publications

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“…As pointed out by Doering et al [23], some preoperative factors may influence postoperative factors also correlated with prolonged length of stay in the ICU. Thus, correlation between prolonged MV and higher age [12], females [12], diabetes [24], hypertension [24], LVEF <30% [24], chronic RF [24] and BMI <20 [25] have been observed. The prolonged MV also correlates with surgical factors such as aortic clamping [24], cardiopulmonary bypass time >120 minutes [25] and other postoperative factors such as RF [25].…”

Section: Bmi -Body Mass Index; Ef -Ejection Fraction; Oi-sc -Oxygenatmentioning

confidence: 99%

Risk factors for prolonged hospital stay after isolated coronary artery bypass grafting

Oliveira¹,

Turquetto²,

Tauil³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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353Rev Bras Cir Cardiovasc | Braz J Cardiovasc SurgRev Bras Cir Cardiovasc 2013;28(3):353- ORIGINAL ARTICLE Abstract Introduction: Characteristics of the patient and the coronary artery bypass grafting may predispose individuals to prolonged hospitalization, increasing costs and morbidity and mortality.Objective: The objective of this study was to evaluate individual and perioperative risk factors of prolonged hospitalization in intensive care units and wards.Methods: We conducted a case-control study of 104 patients undergoing isolated coronary artery bypass grafting with cardiopulmonary bypass. Patients hospitalized >3 days in the intensive care unit or >7 days in the ward were considered for the study. The association between variables was estimated by the chi-square test, odds ratio and logistic regression; P ≤0.05 was considered statistically significant.Results: Hospital stay >3 days in the intensive care unit occurred for 22.1% of patients and >7 days in the ward for 27.9%. Among preoperative factors, diabetes (OR=3.17) and smoking (OR=4.07) were predictors of prolonged intensive care unit stay. Combining the pre-, intra-and postoperative variables, only mechanical ventilation for more than 24 hours (OR=6.10) was predictive of intensive care unit outcome. For the ward outcome, the preoperative predictor was left ventricular ejection fraction <50% (OR=3.04). Combining pre-and intraoperative factors, diabetes (OR=2.81), and including postoperative factors, presence of infection (OR=4.54) were predictors of prolonged hospitalization in the ward.Conclusion: Diabetes and smoking were predictors of intensive care unit outcome, and ejection fraction <50% of ward outcome. For the set of perioperative factors, prolonged hospitalization after isolated coronary artery bypass grafting was associated with mechanical ventilation >24 hours for the intensive care unit and presence of infection for the ward.Descriptors: Risk factors. Myocardial revascularization. Hospitalization. ResumoIntrodução: Características do paciente e da cirurgia de revascularização do miocárdio podem predispor à internação prolongada, aumentando custos e a morbimortalidade.Objetivo: Avaliar fatores de risco individuais e transoperató-rios para internação prolongada na unidade de terapia intensiva e na enfermaria. 354Rev Bras Cir Cardiovasc | Braz J Cardiovasc Surg Bras Cir Cardiovasc 2013;28(3):353-63 Oliveira EK, et al. -Risk factors for prolonged hospital stay after isolated coronary artery bypass grafting productivity [4,8], affecting family budgets, quality of life and increasing costs [1]. Bashour et al. [7] showed that, after cardiac surgery, many patients with prolonged hospital stay died soon after discharge and that the functional status of those who survived for a longer period was worse when compared with those who recovered faster. RevIn this context, the objective of this study was to identify pre-, intra-and postoperative risk factors for long hospitalizations in the ICU or the ward, of patients undergoing isolated CABG surgery w...

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Section: Bmi -Body Mass Index; Ef -Ejection Fraction; Oi-sc -Oxygenatmentioning

confidence: 99%

Risk factors for prolonged hospital stay after isolated coronary artery bypass grafting

Oliveira¹,

Turquetto²,

Tauil³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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“…It has been shown that patients with preexisting low ejection fraction (EF) are at a higher risk of developing respiratory problems than patients with normal EF (11,12,(32)(33)(34)(35)(36). Impaired left ventricular ejection fraction (LVEF) of less than 30%, history of previous myocardial infarction (36,37), and preexisting congestive heart failure, age, diabetes mellitus and arterial hypertension, have all been shown to be independent, significant predictors for developing these respiratory problems (30,31,35). Low EF especially, has a determining role in patients with a preexisting cardiac problem, mainly valvular heart diseases, such as low gradient aortic stenosis (AS).…”

Section: Underlying Function Of the Left Ventriclementioning

confidence: 99%

“…It is also, considered to be a major risk factor for patients undergoing CABG, which could predict the possibility of postoperative mortality and morbidity in these patients, especially for diabetic patients with respiratory problems (30)(31)(32)(33)(34)(35)(36)(37)(38). On the other hand, there is a great amount of current evidence that demonstrates a very clear difference between, well controlled and poorly controlled diabetes mellitus, in predicting respiratory problems, hence, controlling the level of blood glucose in diabetics (at least below 200 mg/dL blood levels) would greatly affect the overall clinical outcome, including respiratory outcomes, in patients undergoing cardiac surgery, especially CABG, compared with poorly controlled diabetics (35)(36)(37).…”

Section: Preexisting Endocrine Disordersmentioning

confidence: 99%

Risk Factors for Postoperative Respiratory Mortality and Morbidity in Patients Undergoing Coronary Artery Bypass Grafting

Rajaei

Dabbagh²

2012

anesthpain

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“…Some authors in their studies refer alternatively to preoperative, intraoperative and immediately postoperative parameters, others showed that hemodynamic status on ICU admission and early postoperative events were more important than intraoperative variables, to predict ventilatory dependence, defined as MV greater than 72 hours after cardiac surgery (Cislaghi et al, 2009;Rajakaruna et al, 2005).…”

Section: Timing Of the Tracheotomymentioning

confidence: 99%

Endoscopic Percutaneous Tracheotomy in Prolonged Intubation of Mechanical Ventilated Patients Admitted in Cardio-Thoracic Intensive Care Unit

Mastropierro¹,

Bettinzoli²,

Manzato³

2012

Global Perspectives on Bronchoscopy

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Predictors of prolonged mechanical ventilation in a cohort of 5123 cardiac surgical patients

Abstract: This review allowed us to assess predictors, helping us to identify 'a priori' patients more likely to undergo PMV.

Cited by 122 publications

References 29 publications

Risk factors for prolonged hospital stay after isolated coronary artery bypass grafting

Risk factors for prolonged hospital stay after isolated coronary artery bypass grafting

Risk Factors for Postoperative Respiratory Mortality and Morbidity in Patients Undergoing Coronary Artery Bypass Grafting

Endoscopic Percutaneous Tracheotomy in Prolonged Intubation of Mechanical Ventilated Patients Admitted in Cardio-Thoracic Intensive Care Unit

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