A derived and validated score to predict prolonged mechanical ventilation in patients undergoing cardiac surgery

Abstract

Prolonged mechanical ventilation after cardiac surgery can be accurately predicted by readily available pre- and intraoperative information.

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

“…Several authors have reported outcomes related to prolonged invasive ventilation after cardiac surgery and developed prediction models mainly using 24-, 36-, or 48-hour thresholds for prolonged invasive ventilation. [26][27][28][29][30][31][32][33] The standard definition of prolonged invasive ventilation according the Society of Thoracic Surgeons is a duration exceeding 24 hours. 13 It has been shown that "time to extubation" after cardiac surgery longer than 16 hours predicts poor clinical outcomes (morbidity, mortality, and reintubation) and that liberation from the ventilator within the first 9 hours is a predictor of better postoperative outcomes.…”

Prolonged mechanical ventilation after left ventricular assist device implantation: risk factors and clinical implications

“…[1][2][3][4][5][6][7][8][9] One recent large-scale study reported a 7% rate of post-operative ventilation for more than 48 h after cardiac surgery with an inhospital death rate of 22.3%. 9 Circulatory assist devices were though excluded from these studies. Our analysis revealed a 43% rate of PMV among LVAD recipients, which is higher than the rates reported in the general cardiac surgery population.…”

“…[1][2][3][4][5][6][7][8][9] Previous studies in patients undergoing general cardiac surgery have reported an incidence of 2-10%, with in-hospital mortality rates exceeding 40%. [1][2][3][4][5][6][7][8][9] Previous studies in patients undergoing general cardiac surgery have reported an incidence of 2-10%, with in-hospital mortality rates exceeding 40%.…”

“…[1][2][3][4][5][6][7][8][9] Previous studies in patients undergoing general cardiac surgery have reported an incidence of 2-10%, with in-hospital mortality rates exceeding 40%. 2,5,6,9 In the setting of advanced heart failure refractory to conventional therapy, the implantation of a left ventricular assist device (LVAD) is nowadays an established treatment option with rapidly expanding indications and availability. Beyond the severity of the heart failure syndrome itself, the significant burden of co-morbidities poses these patients at high risk for post-operative complications such as respiratory failure, right ventricular insufficiency, systemic infections, and multi-organ failure.…”

Effect of iloprost inhalation on postoperative outcome in high-risk cardiac surgical patients: a prospective randomized-controlled multicentre trial (ILOCARD)

“…The primary outcome parameter considered was the duration of postoperative ventilation, which we considered as a surrogate parameter for the severity of critical illness in cardiac surgical patients and is prolonged by PH, RV failure, shock, and prolonged ECC times. [25][26][27]…”