The Risk Factors of Prolonged Mechanical Ventilation after Isolated Coronary Artery Bypass Graft Surgery
Background: Failure to wean a patient from mechanical ventilation after cardiac surgery is associatedwith poor outcome.Aim: The present study was performed aimed to investigate the risk factors of prolonged mechanicalventilation (PMV) following isolated coronary artery bypass graft (CABG) surgery.Me...
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| Format: | Article |
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Mashhad University of Medical Sciences
2023-04-01
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| Series: | Journal of Evidence-Based Care |
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| Online Access: | https://ebcj.mums.ac.ir/article_21506_5a74be6dc1528a6935e9c769b6c18265.pdf |
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| author | Shahram Amini Negar Morovatdar Seyedeh Parisa Karrari Akram Asadpour Mohammad Abbasi Tashnizi Ali Asghar Moeinipoor Mathias Hossain Aazami Mahdieh Jafari |
| author_facet | Shahram Amini Negar Morovatdar Seyedeh Parisa Karrari Akram Asadpour Mohammad Abbasi Tashnizi Ali Asghar Moeinipoor Mathias Hossain Aazami Mahdieh Jafari |
| author_sort | Shahram Amini |
| collection | DOAJ |
| description | Background: Failure to wean a patient from mechanical ventilation after cardiac surgery is associatedwith poor outcome.Aim: The present study was performed aimed to investigate the risk factors of prolonged mechanicalventilation (PMV) following isolated coronary artery bypass graft (CABG) surgery.Method: This retrospective cohort study was performed on 2155 consecutive adult patientsundergoing isolated coronary artery bypass graft surgery (May 2012 to November 2016 at Imam Rezahospital, Mashhad, Iran). The subjects were assessed for duration of weaning from mechanicalventilation, predictive risk factors for prolonged mechanical ventilation and associated outcomesincluding intensive care unit (ICU) and hospital length of stay (LOS), and mortality. Data wereanalyzed by SPSS (version 22). P<0.05 was considered statistically significant.Results: The median (25 -75 percentile) duration of mechanical ventilation was 360 (225-540)minutes. Also, 51.20%, 45.80% and 2.30% patients were weaned from mechanical ventilation in lessthan 6 hours, 7 to 24 hours, and more than 24 hours, respectively. Cerebral vascular accident was themost common cause of PMV (34.04%). After adjustment for confounder variables, on-pump CABG(P<0.05), duration of surgery (P<0.01), preoperative renal failure (P<0.05) and New York HeartAssociation (NYHA) class 4 were associated with PMV (P <0.05). PMV was associated withincreased length of ICU and hospital stay (P<0.01). There was a higher mortality rates in patients withPMV (P<0.001).Implications for Practice: Most patients are weaned from mechanical ventilation within 24 hoursuneventfully after isolated CABG. Furthermore, on-pump CABG, prolonged surgery, preoperativerenal insufficiency, and NYHA class 4 were independent predictors of prolonged mechanicalventilation. Identifying the risk factors causing PMV can prevent its adverse consequences. |
| first_indexed | 2024-04-09T17:52:52Z |
| format | Article |
| id | doaj.art-b6985ec53bf446c6a3262afd0998264c |
| institution | Directory Open Access Journal |
| issn | 2008-2487 2008-370X |
| language | fas |
| last_indexed | 2024-04-09T17:52:52Z |
| publishDate | 2023-04-01 |
| publisher | Mashhad University of Medical Sciences |
| record_format | Article |
| series | Journal of Evidence-Based Care |
| spelling | doaj.art-b6985ec53bf446c6a3262afd0998264c2023-04-15T10:29:08ZfasMashhad University of Medical SciencesJournal of Evidence-Based Care2008-24872008-370X2023-04-0113171410.22038/ebcj.2022.65819.272221506The Risk Factors of Prolonged Mechanical Ventilation after Isolated Coronary Artery Bypass Graft SurgeryShahram Amini0Negar Morovatdar1Seyedeh Parisa Karrari2Akram Asadpour3Mohammad Abbasi Tashnizi4Ali Asghar Moeinipoor5Mathias Hossain Aazami6Mahdieh Jafari7Professor, Department of Anesthesia, Lung Research Center, Mashhad University of Medical Sciences, Mashhad, IranAssistant Professor, Clinical Research Development Unit, Imam Reza hospital, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, IranMD, Anesthesiologist, Department of Anesthesia, Mashhad University of Medical Sciences, Mashhad, IranAssistant Professor, Department of Anesthasiology, School of Medicine, Shahroud University of Medical Sciences, Mashhad, IranProfessor, Department of Cardiac Surgery, Mashhad University of Medical Sciences, Mashhad, IranAssociate Professor, Department of Cardiac Surgery, Mashhad University of Medical Sciences, Mashhad, IranMD, Heart Surgeon, Mashhad University of Medical Sciences, Mashhad, IranAssistant Professor, Anesthesiology, Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranBackground: Failure to wean a patient from mechanical ventilation after cardiac surgery is associatedwith poor outcome.Aim: The present study was performed aimed to investigate the risk factors of prolonged mechanicalventilation (PMV) following isolated coronary artery bypass graft (CABG) surgery.Method: This retrospective cohort study was performed on 2155 consecutive adult patientsundergoing isolated coronary artery bypass graft surgery (May 2012 to November 2016 at Imam Rezahospital, Mashhad, Iran). The subjects were assessed for duration of weaning from mechanicalventilation, predictive risk factors for prolonged mechanical ventilation and associated outcomesincluding intensive care unit (ICU) and hospital length of stay (LOS), and mortality. Data wereanalyzed by SPSS (version 22). P<0.05 was considered statistically significant.Results: The median (25 -75 percentile) duration of mechanical ventilation was 360 (225-540)minutes. Also, 51.20%, 45.80% and 2.30% patients were weaned from mechanical ventilation in lessthan 6 hours, 7 to 24 hours, and more than 24 hours, respectively. Cerebral vascular accident was themost common cause of PMV (34.04%). After adjustment for confounder variables, on-pump CABG(P<0.05), duration of surgery (P<0.01), preoperative renal failure (P<0.05) and New York HeartAssociation (NYHA) class 4 were associated with PMV (P <0.05). PMV was associated withincreased length of ICU and hospital stay (P<0.01). There was a higher mortality rates in patients withPMV (P<0.001).Implications for Practice: Most patients are weaned from mechanical ventilation within 24 hoursuneventfully after isolated CABG. Furthermore, on-pump CABG, prolonged surgery, preoperativerenal insufficiency, and NYHA class 4 were independent predictors of prolonged mechanicalventilation. Identifying the risk factors causing PMV can prevent its adverse consequences.https://ebcj.mums.ac.ir/article_21506_5a74be6dc1528a6935e9c769b6c18265.pdfcoronary artery bypass graft surgerymechanical ventilationweaning |
| spellingShingle | Shahram Amini Negar Morovatdar Seyedeh Parisa Karrari Akram Asadpour Mohammad Abbasi Tashnizi Ali Asghar Moeinipoor Mathias Hossain Aazami Mahdieh Jafari The Risk Factors of Prolonged Mechanical Ventilation after Isolated Coronary Artery Bypass Graft Surgery Journal of Evidence-Based Care coronary artery bypass graft surgery mechanical ventilation weaning |
| title | The Risk Factors of Prolonged Mechanical Ventilation after Isolated Coronary Artery Bypass Graft Surgery |
| title_full | The Risk Factors of Prolonged Mechanical Ventilation after Isolated Coronary Artery Bypass Graft Surgery |
| title_fullStr | The Risk Factors of Prolonged Mechanical Ventilation after Isolated Coronary Artery Bypass Graft Surgery |
| title_full_unstemmed | The Risk Factors of Prolonged Mechanical Ventilation after Isolated Coronary Artery Bypass Graft Surgery |
| title_short | The Risk Factors of Prolonged Mechanical Ventilation after Isolated Coronary Artery Bypass Graft Surgery |
| title_sort | risk factors of prolonged mechanical ventilation after isolated coronary artery bypass graft surgery |
| topic | coronary artery bypass graft surgery mechanical ventilation weaning |
| url | https://ebcj.mums.ac.ir/article_21506_5a74be6dc1528a6935e9c769b6c18265.pdf |
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