Factors associated with extubation time in coronary artery bypass grafting patients

Abstract

Background and Objectives. Cardiovascular diseases are the leading cause of death worldwide, with coronary artery disease being the most common. With increasing numbers of patients, Coronary Artery Bypass Grafting (CABG) has become the most common operation in the world. Respiratory disorder is one of the most prevalent complications of CABG. Thus, weaning off the mechanical ventilation and extubation are of great clinical importance for these patients. Some post-operative problems also relate to the tracheal tube and mechanical ventilation. Therefore, an increase in this leads to an increase in the number of complications, length of hospital stay, and treatment costs. Since a large number of factors affect the post-operative period, the present study aims to identify the predictors of extubation time in CABG patients using casualty network analysis.Method. This longitudinal study was conducted on 800 over 18 year old patients who had undergone CABG surgery in three treatment centers affiliated to Shiraz University of Medical Sciences. The patients’ information, including pre-operative, peri-operative, and post-operative variables, was retrospectively extracted from their medical records. Then, the data was comprehensively analyzed through path analysis using MPLUS-7.1 software.Results. The mean of extubation time was 10.27 + 4.39 h. Moreover, extubation time was significantly affected by packed cells during the Cardiopulmonary Bypass (CPB), packed cells after CPB, inotrope use on arrival at ICU, mean arterial pressure 1st ICU, packed cells 1st ICU, platelets 1st ICU, Blood Urea Nitrogen 1st ICU, and hematocrit 1st ICU.Conclusion. Considering all of the factors under investigation, some peri-operative and post-operative factors had significant effects. Therefore, considering the post-operative factors is important for designing a treatment plan and evaluating patients’ prognosis.

Comparing the Effectiveness of Patient Control Analgesia Pump and Bolus Morphine in Controlling Pain After Cardiopulmonary Bypass Graft Surgery

“…Furthermore, post-operative problems can be associated with tracheal tube and mechanical ventilation. Hence, increased problems can induce higher risk of complications and increase duration of hospitalization and costs ( 41 ). In addition, further investigations on the effect of other opioid and non-opioid drugs on PCA pump and their analgesic effect are recommended to determine the most appropriate drug with the least complication.…”

Cardaic Surgery; Risk Factors of Delayed Extubation

“…Rezaianzadeh et al did not found effect of female gender on delayed extubation. 13 Suematsu et al 3 also did not found female gender as a risk factor of delayed extubation.…”

“…Rezaianzadeh et al 13 reported that need of packed cells and inotropes during and after cardiopulmonary bypass and low arterial pressures after surgery are risk factors of delayed extubation after cardiac surgery.…”

Korelasi antara Lama Pintas Jantung Paru dan Lama Bantuan Ventilasi Mekanis pada Pasien Pascabedah Pintas Arteri Koroner di Unit Perawatan Intensif Jantung Rumah Sakit Dr. Hasan Sadikin Bandung

“…Suatu penelitian menyatakan 2,6-22,7% pasien pascabedah jantung terbuka memerlukan ventilasi mekanis jangka panjang dan sekitar 7% pasien dilakukan reintubasi Penelitian terbaru memfokuskan pada identifikasi faktor risiko preoperatif, intraoperatif, serta pascaoperatif yang berhubungan dengan lama bantuan ventilasi mekanis yang dapat memprediksi prognosis dan hasil luaran pasien BPAK. [2][3][4][5][6] Penelitian menyatakan bahwa mesin PJP menyebabkan perubahan pada paru yang meliputi elastisitas, daya regang dan resistensi, serta perubahan permeabilitas pada pembuluh darah paru. Disfungsi paru pascaoperasi jantung terbuka memiliki etiologi yang sangat kompleks, terutama disebabkan oleh respons inflamasi sistemik yang dicetuskan oleh pintas jantung paru dan meningkatkan permeabilitas endotel paru.…”