Factors associated to the length of time on mechanical ventilation in the postoperative period of cardiac surgery

Fonseca, Laura; Vieira, Fernando Nataniel; Azzolin, Karina de Oliveira

doi:10.1590/1983-1447.2014.02.44697

Cited by 12 publications

(13 citation statements)

References 14 publications

(18 reference statements)

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“…As regards to smoking habits, there was a higher frequency of smoking patients. It was found that the results are consistent with those observed in the literature, given the high prevalence of smokers in other studies (OLIVEIRA et al, 2013;FONSECA;VIEIRA;AZZOLIN, 2014).…”

Section: Discussionsupporting

confidence: 91%

Factors associated with intubation extended in patients who undewent a heart surgery

et al. 2017

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ABSTRACT:This study was accomplished in order to identify the factors associated with prolonged intubation in patients who underwent cardiac surgery. This is a retrospective, analytical study, with a quantitative approach, performed in a large teaching hospital in the municipality of Uberaba (Minas Gerais). The data were collected from records of patients who underwent cardiac surgery. In order to identify the factors that may be associated with a prolonged intubation, a bivariate and a latter multivariate analysis were performed. The significance level was 0.05. the study population was constituted by 460 individuals. From these, 150 (32.6%) had prolonged intubation time (over 24 hours). The majority were male (60.9%) and the average age was 55.60 years (± 12.9). The results also showed that age over 60 years, the occurrence of pulmonary infection, the presence of comorbidities, intraoperative complications and the duration of the cardiopulmonary bypass were associated with the occurrence of prolonged intubation in these patients. Considering that prolonged intubation can often contribute to the occurrence of other complications in the postoperative period of a cardiac surgery, it is emphasized the importance of a careful preoperative evaluation. The findings of this study may contribute to the adoption of preventive measures in the clinical practice, with a view to the patient's safety and the quality of care.

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Section: Discussionsupporting

confidence: 91%

Factors associated with intubation extended in patients who undewent a heart surgery

et al. 2017

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“…Several reports (e.g. by Hantschel et al) have shown the cost-effectiveness of this approach ( 15 , 16 ). Zhu et al demonstrated that low-dose opioid anesthesia and early extubation approach reduce the ventilation time by 7.40 hours ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

Feasibility of On-table Extubation After Cardiac Surgery with Cardiopulmonary Bypass: A Randomized Clinical Trial

et al. 2018

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BackgroundThe use of short-acting anesthetics, muscle relaxation, and anesthesia depth monitoring allows maintaining sufficient anesthesia depth, fast recovery, and extubation of the patients in the operating room (OR). We evaluated the feasibility of extubation in the OR in cardiac surgery.MethodsThis clinical trial was performed on 100 adult patients who underwent elective noncomplex cardiac surgery using cardiopulmonary bypass. Additional to the routine monitoring, the patients’ depth of anesthesia and neuromuscular blocked were assessed by bispectral index and nerve stimulator, respectively. In the on-table extubation (OTE) group (n = 50), a limited dose of sufentanil (0.15 µg/kg/h) and inhalational anesthetics were used for early waking. In the control group (n = 50), the same anesthesia-inducing drugs were used but the dose of sufentanil during the operation was 0.7 - 0.8 µg/kg/h. After the operation, cardiorespiratory parameters and ICU stay were documented.ResultsDemographic and clinical variables were comparable in both study groups. In the OTE group, we failed to extubate two patients in the OR (success rate of 96%). There were no significant differences between the two groups in terms of systolic and diastolic blood pressure at the time of entering the ICU (P > 0.05). Heart rate was lower in the OTE than in the control group at ICU admission (89.4 ± 13.1 vs. 97.6 ± 12.0 bpm; P = 0.008). The ICU stay time was lower in the OTE group (34 (21.5 - 44) vs. 48 (44 - 60) h; P = 0.001).ConclusionsCombined inhalational-intravenous anesthesia along with using multiple anesthesia monitoring systems allows reducing the dose of total anesthetics and maintaining adequate anesthesia depth during noncomplex cardiac surgery with cardiopulmonary bypass. Thus, extubation of the trachea in the OR is feasible in these patients.

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“…One of the causes of the high success in weaning from mechanical ventilator in the 2 groups is that these diseases were not significant in these 2 groups although the duration of weaning from mechanical ventilator in the experimental group was 1.4 time less than the control group. Studies have indicated that preoperative, transoperative, and postoperative variables are related to the prolonged mechanical ventilation time (27). Some studies have found that some demographic factors such as age (28), heart surgery, and underlying factors such as the number of heart surgery, and the amount of ejection fraction (29), and underlying diseases such as the history of mental disease, diabetes mellitus, and hyperlipidemia (30) can independently predict complications after heart surgery such as the longtime of weaning from mechanical ventilator.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Family-Centered Care on the Duration of Weaning From Mechanical Ventilation in Coronary Artery Bypass Surgery Patients: A Clinical Trial Study

Safaeepour¹,

Nouri²,

Moradian³

et al. 2017

Crit Care Nurs J

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Background: The use of nonpharmacological methods has been emphasized in the recent years. These methods are used to decrease the duration of weaning from mechanical ventilation after coronary artery bypass graft (CABG) surgery. Objectives: The present study aimed at determining the effect of family-centered care on the duration of weaning from mechanical ventilation in patients undergoing CABG. Methods: This clinical trial study was conducted in Jamaran Heart Subspecialty hospital in Tehran in 2016. Initially, convenient sampling method and random allocation were used by quaternary blocks to allocate patients into 2 groups of experimental and control, with 35 participants in each group. In the intervention group, the patients' family member chosen by the patient was entered into the ward during the weaning process. Patient's entrance time to the ward to extubation time was considered as the duration of weaning from mechanical ventilation in the 2 groups. Results: Duration of weaning in the experimental group was 97 minutes less than the control group; in other words, the weaning duration of those in the control group was 1.4 times greater than those in the experimental group. This difference was statistically significant between the 2 groups (P = 0.05). Conclusions: Family-centered care reduced the duration of weaning from mechanical ventilator in patients undergoing coronary artery surgery, which can remarkably decrease complications due to ventilation with positive pressure in these patients.

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Factors associated to the length of time on mechanical ventilation in the postoperative period of cardiac surgery

Cited by 12 publications

References 14 publications

Factors associated with intubation extended in patients who undewent a heart surgery

Factors associated with intubation extended in patients who undewent a heart surgery

Feasibility of On-table Extubation After Cardiac Surgery with Cardiopulmonary Bypass: A Randomized Clinical Trial

The Effect of Family-Centered Care on the Duration of Weaning From Mechanical Ventilation in Coronary Artery Bypass Surgery Patients: A Clinical Trial Study

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