Prolonged Mechanical Ventilation Following Coronary Artery Bypass Graft in Santiago De Cali, Colombia

Jorge Enrique Daza-Arana,1 Heiler Lozada-Ramos,2,3 Daniel Felipe Ávila-Hernández,1 Leidy Tatiana Ordoñez-Mora,1 Diana Patricia Sánchez1 1Physiotherapy Program, Universidad Santiago de Cali, Cali, Colombia; 2Medicine Program, Universidad Santiago de Cali, Cali, Colombia; 3Doctoral Program in Infectio...

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Main Authors: Daza-Arana JE, Lozada-Ramos H, Ávila-Hernández DF, Ordoñez - Mora LT, Sánchez DP
Format: Article
Language:English
Published: Dove Medical Press 2022-09-01
Series:Vascular Health and Risk Management
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Online Access:https://www.dovepress.com/prolonged-mechanical-ventilation-following-coronary-artery-bypass-graf-peer-reviewed-fulltext-article-VHRM
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Summary:Jorge Enrique Daza-Arana,1 Heiler Lozada-Ramos,2,3 Daniel Felipe Ávila-Hernández,1 Leidy Tatiana Ordoñez-Mora,1 Diana Patricia Sánchez1 1Physiotherapy Program, Universidad Santiago de Cali, Cali, Colombia; 2Medicine Program, Universidad Santiago de Cali, Cali, Colombia; 3Doctoral Program in Infectious Diseases, Universidad de Santander – UDES, Bucaramanga, ColombiaCorrespondence: Jorge Enrique Daza-Arana, Physiotherapy Program, Universidad Santiago de Cali, Calle 5 No. 62-00 Pampalinda, Cali, Colombia, Tel +57 3108923676, Email jorgedaz921@gmail.comPurpose: The purpose of this study was to describe factors associated with prolonged ventilatory support in subjects undergoing coronary artery bypass graft.Patients and Methods: This was an analytical retrospective case–control study. Cases were defined as subjects requiring prolonged mechanical ventilation (> 48 hours) following isolated coronary artery bypass graft. Subjects older than 18 years who had undergone surgery were included, while subjects with missing clinical record data, subjects in coma or subjects with prior cardiac surgery were excluded. Variables were measured at the three time points surrounding surgery.Results: A total of 204 cases and 408 controls were included. The final logistic model showed an association between prolonged mechanical ventilation and the following presurgical variables: chronic obstructive pulmonary disease (OR 1.85; 95% CI: 1.06– 3.23, p = 0.03) and chronic kidney disease (OR 1.90; 95% CI: − 3.31; p = 0.02). The associated transurgical variable was the use of intra-aortic balloon pump (OR 3.63; 95% CI: 1.73– 7.61, p = 0.00), and associated postsurgical variables were venous oxygen saturation < 60% (OR 2.00; 95% CI: 1.18– 3.40, p = 0.01), mediastinitis (OR 18.51; 95% CI: 4.06– 84.40, p = 0.00), inotrope use (OR 2.82; 95% CI: 1.77– 4.48, p = 0.00), pleural effusion requiring drainage (OR 3.57; 95% CI: 2.02– 6.32, p = 0.00) and delirium (OR 3.45; 95% CI: 1.91– 6.25, p = 0.00).Conclusion: This study identifies factors associated with prolonged mechanical ventilation in subjects subject to coronary artery bypass graft over the presurgical, transurgical and postsurgical periods, identifying a new factor, delirium, for this type of population.Keywords: coronary bypass, prolonged ventilatory support, risk factor, cardiac surgery, epidemiology
ISSN:1178-2048