The Effects of Escalation of Respiratory Support and Prolonged Invasive Ventilation on Outcomes of Cardiac Surgical Patients: A Retrospective Cohort Study.

Zochios, Vasileios and Chandan, Joht Singh and Schultz, Marcus J and Morris, Andrew Conway and Parhar, Ken Kuljit and Giménez-Milà, Marc and Gerrard, Caroline and Vuylsteke, Alain and Klein, Andrew A (2019) The Effects of Escalation of Respiratory Support and Prolonged Invasive Ventilation on Outcomes of Cardiac Surgical Patients: A Retrospective Cohort Study. Journal of cardiothoracic and vascular anesthesia. ISSN 1532-8422.

Full text not available from this repository.
Official URL: https://www.jcvaonline.com/article/S1053-0770(19)3...

Abstract

OBJECTIVES

The aim of this study was to determine the effects of escalation of respiratory support and prolonged postoperative invasive ventilation on patient-centered outcomes, and identify perioperative factors associated with these 2 respiratory complications.

DESIGN

A retrospective cohort analysis of cardiac surgical patients admitted to the cardiothoracic intensive care unit (ICU) between August 2015 and January 2018. Escalation of respiratory support was defined as "unplanned continuous positive airway pressure," "non-invasive ventilation," or "reintubation" after surgery; prolonged invasive ventilation was defined as "invasive ventilation beyond the first 12 hours following surgery." The primary endpoint was the composite of escalation of respiratory support and prolonged ventilation.

SETTING

Tertiary cardiothoracic ICU.

PARTICIPANTS

A total of 2,098 patients were included and analyzed.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

The composite of escalation of support or prolonged ventilation occurred in 509 patients (24.3%). Patients who met the composite had higher mortality (2.9% v 0.1%; p < 0.001) and longer median [interquartile range] length of ICU (2.1 [1.0-4.9] v 0.9 [0.8-1.0] days; p < 0.0001) and hospital (10.6 [8.0-16.0] v 7.2 [6.2-10.0] days; p < 0.0001) stay. Hypoxemia and anemia on admission to ICU were the only 2 factors independently associated with the need for escalation of respiratory support or prolonged invasive ventilation.

CONCLUSIONS

Escalation of respiratory support or prolonged invasive ventilation is frequently seen in cardiac surgery patients and is highly associated with increased mortality and morbidity. Hypoxemia and anemia on admission to the ICU are potentially modifiable factors associated with escalation of respiratory support or prolonged invasive ventilation.

Item Type: Article
Subjects: WF Respiratory system. Respiratory medicine
WG Cardiovascular system. Cardiology
WO Surgery
Divisions: Clinical Support > Anaesthetics
Clinical Support > Critical Care
Related URLs:
Depositing User: Beth Connors
Date Deposited: 17 Dec 2019 12:16
Last Modified: 17 Dec 2019 12:16
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2694

Actions (login required)

View Item View Item