Oxygenation impairment after total arch replacement with a stented elephant trunk for type-A dissection

Shen, Yuwen; Liu, Chuanzhen; Fang, Changcun; Xiao, Jie; Wu, Shanshan; Pang, Xinyan; Song, Guanhua

doi:10.1016/j.jtcvs.2018.01.085

Cited by 20 publications

(27 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our ARD patients required a longer time of ventilation with an extended stay in the ICU, tended to develop pneumonia and underwent tracheotomy more often than NON-ARD patients. This finding is supported by other studies who had similar results [7,8,12]. This study demonstrated that higher age and an increased BMI are risk factors for the development of ARD after acute type A aortic dissection surgery.…”

Section: Plos Onesupporting

confidence: 90%

“…In contrast, Girdauskas et al and Chen et al also excluded patients with cardiogenic pulmonary edema, pneumonia, pulmonary embolism or hemo-/pneumothorax [7,8]. Interestingly, studies with a comparable definition of ARD and no defined exclusion criteria showed a similar incidence of 48.5% for ARD [12]. Our ARD patients required a longer time of ventilation with an extended stay in the ICU, tended to develop pneumonia and underwent tracheotomy more often than NON-ARD patients.…”

Section: Plos Onementioning

confidence: 70%

“…Postoperative ARD is a typical complication after non-cardiac and cardiac surgery [15,16]. The incidence of ARD after surgery for acute type A aortic dissection is 8-48.5% [5,7,8,12]. The respective studies have usually defined ARD on the basis of the Berlin definition for ARDS [13].…”

Section: Discussionmentioning

confidence: 99%

“…Currently, there is no standardized definition for ARD after acute type A aortic dissection surgery [5,7,8,12]. Therefore, we used the latest Berlin definition for moderate acute respiratory distress syndrome (ARDS) and defined ARD as PaO 2 /FiO 2 (PF ratio) � 200 mmHg in at least four out of six BGA within 48 hours after admission to the ICU [13].…”

Section: Ard Definitionmentioning

confidence: 99%

See 3 more Smart Citations

Postoperative acute respiratory dysfunction and the influence of antibiotics after acute type A aortic dissection surgery: A retrospective analysis

et al. 2021

View full text Add to dashboard Cite

Objectives Surgery for acute type A aortic dissection is associated with several perioperative complications, such as acute respiratory dysfunction (ARD). The aim of this study was to investigate perioperative risk factors involved in the development of ARD and whether antibiotic treatment has an impact. Methods 243 patients underwent surgery for acute type A aortic dissection between 2008 and 2017. The patients were retrospectively divided into the ARD and NON-ARD group. ARD was defined as PaO2/FiO2 ≤ 200 mmHg (PF ratio) within 48 hours after surgery. All patients received either narrow- or broad-spectrum antibiotics. Results After the exclusion of 42 patients, 201 patients were analyzed. The PF ratio of the ARD group was significantly lower than of the NON-ARD group within the first 7 days. ARD patients (n = 111) were significantly older (p = .031) and had a higher body mass index (BMI) (p = .017). ARD patients required longer postoperative ventilation (2493 vs. 4695 [min], p = .006) and spent more days in the intensive care unit (7.0 vs. 8.9 [days], p = .043) compared to NON-ARD. The mortality was significantly lower for ARD than for NON-ARD patients (p = .030). The incidence of pneumonia was independent of the antibiotic treatment regime (p = .391). Renal and neurological complication rate was higher in patients treated with broad-spectrum antibiotic. Conclusion ARD is the main complication (55%) that occurs approximately 24 hours after surgery for acute type A aortic dissection. The preoperative risk factors for ARD were higher age and increased BMI. Patients on broad-spectrum antibiotics did not show an improved postoperative outcome compared to patients with narrow-spectrum antibiotics.

show abstract

Section: Plos Onesupporting

confidence: 90%

Section: Plos Onementioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Ard Definitionmentioning

confidence: 99%

See 2 more Smart Citations

Postoperative acute respiratory dysfunction and the influence of antibiotics after acute type A aortic dissection surgery: A retrospective analysis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Multiple factors could be associated with the development of hypoxemia after TAAD repair, such as dissection-induced inflammatory response, cardiopulmonary bypass, lung atelectasis, and ischemic reperfusion injury [2]. Postoperative hypoxemia prolongs the duration of mechanical ventilation and intensive care unit (ICU) stay, and increases the chances of hospital-acquired pneumonia, re-intubation and tracheostomy, and risk of death [2,3].…”

Section: Introductionmentioning

confidence: 99%

Is Obstructive Sleep Apnoea Associated with Hypoxemia and Prolonged ICU Stay after Type A Aortic Dissection Repair?

Xin

Chen

et al. 2021

Preprint

View full text Add to dashboard Cite

Background : Although obstructive sleep apnoea (OSA) is prevalent among patients with aortic dissection, its prognostic impact is not yet determined in patients undergoing major vascular surgery. We aimed to investigate the association of OSA with hypoxemia and with prolonged intensive care unit (ICU) stay after type A aortic dissection (TAAD) repair. Methods: This study enrolled 83 patients who underwent TAAD repair. OSA diagnosis was confirmed by a preoperative STOP-BANG questionnaire and a sleep test performed within 90 days postoperatively. OSA was defined as an apnoea hypopnea index (AHI) of ≥15/h, while an AHI of >30/h was defined severe OSA. Hypoxemia was defined as an oxygenation index (OI) of <200 mmHg, 6 h postoperatively and prolonged ICU referred to an ICU stay of >72 h. Multivariable analysis was performed to assess the association of OSA with hypoxemia and prolonged ICU stay. Results: OSA was diagnosed in 41 patients (49.4%), which was consistent with the detection by using a preoperative STOP-BANG score of ≥4 (Kappa=0.424, P<0.01). Hypoxemia occurred postoperatively in 56 patients (67.5%). Postoperatively hypoxemia developed mostly in OSA patients (52.4% vs. 83.0%, P<0.01), and particularly in those with severe OSA ( 52.4% vs. 90.5%, P<0.01). The postoperative OI could fairly predict a prolonged ICU stay (area under the curve, 0.719; 95% CI 0.595-0.843; P=0.002). Severe OSA was a predictor of both postoperative hypoxemia (odds ratio [OR] 6.65; 95% CI 1.56-46.26, P<0.01) and prolonged ICU stay (OR 5.58; 95% CI 1.54-20.24, P<0.01). Conclusions: OSA was common in patients with TAAD. Severe OSA was predictive of hypoxemia and prolonged ICU stay after TAAD repair. The STOP-BANG score may offer diagnostic clues to OSA in patients with TAAD.

show abstract

Perioperative Risk Factors for Post-operative Pneumonia after Type A Acute Aortic Dissection Surgery

Hua

Kong

et al. 2022

CURR MED SCI

View full text Add to dashboard Cite

Oxygenation impairment after total arch replacement with a stented elephant trunk for type-A dissection

Cited by 20 publications

References 28 publications

Postoperative acute respiratory dysfunction and the influence of antibiotics after acute type A aortic dissection surgery: A retrospective analysis

Postoperative acute respiratory dysfunction and the influence of antibiotics after acute type A aortic dissection surgery: A retrospective analysis

Is Obstructive Sleep Apnoea Associated with Hypoxemia and Prolonged ICU Stay after Type A Aortic Dissection Repair?

Perioperative Risk Factors for Post-operative Pneumonia after Type A Acute Aortic Dissection Surgery

Contact Info

Product

Resources

About