Risk Factors of Prolonged Mechanical Ventilation in Patients Undergoing Redo Valve Surgery

Xiao, Ya-qiong; Xu, Jianping; Zhao, Can; Pan, Gang

doi:10.1532/hsf.4913

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…The results are below than those reported in burns with ABSI with predicted mortality between 55 and 82%, which suggest prolonged mechanical ventilation for more than 21 days, difficult weaning, in addition to pneumonia and ventilator-induced lung injury. 5 The increase in mechanical power values during prone positioning is related to death, 23 in this research we found a significant reduction in mechanical power with mortality below that predicted by the specific ABSI index for burns.…”

Section: Discussionmentioning

confidence: 45%

“…3 ARDS can result from inhalation injury, and it becomes more serious when it is combined with SIRS generated by extensive and deep burns. 4 Mechanical ventilation is an essential support for severely burned patients 5 with the intention of ensuring sufficient hematosis (the conversion of venous into arterial blood, i.e. oxygenation and CO2 removal i.e.…”

Section: Introductionmentioning

confidence: 99%

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Effects of the prone position on gas exchange and ventilatory mechanics and their correlations with mechanical power in burn patients with ARDS

Franck,

Daoud

2024

JMV

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Background Prone position has many documented benefits on severe ARDS patients especially on mortality. The benefits in ARDS secondary to severe burns have not been fully documented. Aim To quantify the effects of prone positioning on gas exchange, ventilatory mechanics and their correlations with mechanical power in burn subjects with ARDS. Methods Cross-sectional observational analytical study that took place between January 2023 and October 2023 in Burns ICU in Brazil on subjects with moderate to severe ARDS ventilated with the volume controlled mode. Data were collected in the first prone positioning lasting 24 hours in the first 30 minutes after changing position and 30 minutes before returning to the supine position. The parameters of the components of mechanical ventilation and mechanical power calculated by the Gatinoni’s formula (respiratory rate, tidal volume, driving pressure, PEEP, peak and plateau pressures) were collected to evaluate ventilatory mechanics, and the values of the FiO2, PaO2, PaO2/FiO2 ratio, SpO2, EtCO2, PaCO2, PaCO2 - EtCO2 gradient to assess gas exchange. Mean, minimum and maximum values, 1st and 3rd quartiles, median and standard deviation are calculated. To compare the results obtained at the two evaluation moments, the student’s t-test for dependent samples and non-parametric Wilcoxon tests were considered. To evaluate the association between the variation between the two moments of each variable, and the variation in mechanical power, the Pearson correlation coefficient was calculated. The normality of the variables was assessed using the Jarque-Béra test. P values <0.05 indicated statistical significance. Results Except for EtCO2 (P 0.939) and PaCO2 (P 0.391) all other variables presented statistical significance in relation to their variations with reduction in FiO2 (P <0.001), reduction in PaCO2 - EtCO2 gradient (P 0.011), and increases in PaO2 (P 0.008), PaO2/FiO2 (P <0.001), SpO2 (P 0.004). In the analysis of variables, reduction in respiratory rate (P 0.142), VT (P 0.385), peak pressure (P 0.085), plateau pressure (P 0.009), PEEP (P 0.032), driving pressure (P 0.083), elastance (P 0.180), mechanical power (P < 0.001) with increase static compliance (P 0.414) and resistance pressure (P 0.443). Among the ventilatory mechanics variables, only the reductions in plateau pressure, PEEP, and mechanical power showed statistical significance. Conclusion The prone position in burns induced ARDS improved oxygenation and reduced arterial partial pressure to end tidal CO2 gradient, furthermore, reducing plateau pressures and PEEP, which in turn reduced mechanical power. Keywords: mechanical power, burns, ARDS, prone position

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Section: Discussionmentioning

confidence: 45%

Section: Introductionmentioning

confidence: 99%

Effects of the prone position on gas exchange and ventilatory mechanics and their correlations with mechanical power in burn patients with ARDS

Franck,

Daoud

2024

JMV

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Risk factors and early outcomes of prolonged mechanical ventilation following redo aortic arch surgery: A retrospective study

Chen,

Zhao

et al. 2024

Heart & Lung

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The Incidence, Risk Factors, and Hospital Mortality of Prolonged Mechanical Ventilation among Cardiac Surgery Patients: A Systematic Review and Meta-Analysis

Wang,

Tao,

Zhang

et al. 2024

Rev. Cardiovasc. Med.

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Background: Prolonged mechanical ventilation (PMV) is a common complication after cardiac surgery and is considered a risk factor for poor outcomes. However, the incidence and in-hospital mortality of PMV among cardiac surgery patients reported in studies vary widely, and risk factors are controversial. Methods: We searched four databases (Web of Science, Cochrane Library, PubMed, and EMBASE) for English-language articles from inception to October 2023. The odds ratio (OR), 95% confidence interval (CI), PMV incidence, and in-hospital mortality were extracted. Statistical data analysis was performed using Stata software. We calculated the fixed or random effects model according to the heterogeneity. The quality of each study was appraised by two independent reviewers using the Newcastle–Ottawa scale. Results: Thirty-two studies were included. The incidence of PMV was 20%. Twenty-one risk factors were pooled, fifteen risk factors were found to be statistically significant (advanced age, being female, ejection fraction <50, body mass index (BMI), BMI >28 kg/m2, New York Heart Association Class ≥Ⅲ, chronic obstructive pulmonary disease, chronic renal failure, heart failure, arrhythmia, previous cardiac surgery, higher white blood cell count, creatinine, longer cardiopulmonary bypass (CPB) time, and CPB >120 min). In addition, PMV was associated with increased in-hospital mortality (OR, 14.13, 95% CI, 12.16–16.41, I2 = 90.3%, p < 0.01). Conclusions: The PMV incidence was 20%, and it was associated with increased in-hospital mortality. Fifteen risk factors were identified. More studies are needed to prevent PMV more effectively according to these risk factors. The PROSPERO Registration: This systematic review and meta-analysis was recorded at PROSPERO (CRD42021273953, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=273953).

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Risk Factors of Prolonged Mechanical Ventilation in Patients Undergoing Redo Valve Surgery

Cited by 3 publications

References 20 publications

Effects of the prone position on gas exchange and ventilatory mechanics and their correlations with mechanical power in burn patients with ARDS

Effects of the prone position on gas exchange and ventilatory mechanics and their correlations with mechanical power in burn patients with ARDS

Risk factors and early outcomes of prolonged mechanical ventilation following redo aortic arch surgery: A retrospective study

The Incidence, Risk Factors, and Hospital Mortality of Prolonged Mechanical Ventilation among Cardiac Surgery Patients: A Systematic Review and Meta-Analysis

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