Document Detail


Causes of prolonged mechanical ventilation after coronary artery bypass surgery.
MedLine Citation:
PMID:  12114366     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To evaluate causes of failure to be extubated (FTE) after coronary artery bypass graft (CABG) surgery. DESIGN: Prospective observational study. SETTING: Cardiovascular surgical ICU. PATIENTS: Four hundred patients undergoing CABG surgery. Following surgery, patients were extubated by a standardized respiratory protocol and were assessed at 8, 24, and 48 h. Patients who could not be extubated at 8 h were designated as FTE, and at 24 and 48 h they were labeled as requiring prolonged mechanical ventilation (PMV) > 24 h and PMV > 48 h, respectively. MEASUREMENTS AND RESULTS: One hundred sixty-seven patients (41.75%), 27 patients (6.75%), and 21 (5.25%) patients, respectively, could not be extubated at 8, 24, and 48 h. Depressed level of consciousness was the most common reason for FTE in 58 of 167 patients (34.7%). The main cause of depressed level of consciousness was prolonged sedation due to anesthetic agents (51 patients; 30.5%). Hypoxemia was the most common cause for PMV for > 24 h (15 patients) and PMV > 48 h (13 patients). The causes of hypoxemia were cardiogenic and noncardiogenic pulmonary edema, pneumonia, and "hypoxemia of unknown etiology." Tachypnea due to acid-base disturbances was a reason for FTE and PMV for > 24 h in 27 and 3 patients, respectively. Cardiovascular instability was a rare reason for FTE. Postoperative bleeding was a cause for PMV in 18 patients. Four patients had more than a single reason for FTE at each assessment. Different causes have a variable effect on the duration of mechanical ventilation. CONCLUSION: The causes of PMV are heterogeneous, vary with time, and have a variable impact on the duration of mechanical ventilation required after the patient undergoes CABG surgery.
Authors:
Sachin Yende; Richard Wunderink
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Chest     Volume:  122     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-12     Completed Date:  2002-07-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  245-52     Citation Subset:  AIM; IM    
Affiliation:
Physician Research Network, Methodist Healthcare University Hospital, Memphis, TN, USA. yende@juno.com
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MeSH Terms
Descriptor/Qualifier:
Coronary Artery Bypass*
Female
Hospital Mortality
Humans
Intensive Care Units
Male
Middle Aged
Postoperative Complications / therapy*
Postoperative Period
Prospective Studies
Respiration, Artificial*
Ventilator Weaning / statistics & numerical data*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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