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Prolonged pulmonary support after cardiac surgery: incidence, risk factors and outcomes: a retrospective cohort study.

Publication ,  Journal Article
Bartz, RR; Ferreira, RG; Schroder, JN; Davies, J; Liu, W-W; Camara, A; Welsby, IJ
Published in: J Crit Care
October 2015

BACKGROUND: Post-cardiac surgery pulmonary dysfunction may be underreported. Therefore, we evaluated associated risk factors for prolonged pulmonary support after cardiac surgery. METHODS AND MATERIALS: We conducted a retrospective, observational study of consecutive patients undergoing coronary artery bypass grafting or coronary artery bypass grafting plus valve repair/replacement between Jan 1, 2005, and Dec 31, 2010, at an academic medical center. Using multivariate logistic regression and Cox proportional hazards modeling, we identified risk factors associated with prolonged mechanical ventilation and supplemental O2 support as well as in-hospital mortality. RESULTS: Overall, 33% (1298/3881) of patients required more than 2 days of mechanical ventilation and/or more than 5 days of supplemental O2 (prolonged support). Independent risk factors included age, weight, pre-existing lung disease, cardiac or renal dysfunction, emergent status, transfusion and cardiopulmonary bypass duration. Prolonged support was associated with increased mortality (OR, 4.75; 95% CI, 2.95-7.95; P < .001). Radiological evidence of persistent pulmonary edema 2 days after surgery was found in 4% of controls and 27% of prolonged support cases. CONCLUSIONS: We identified risk factors for prolonged mechanical ventilation and supplemental O2 use, described an association with increased adverse outcomes, and determined that persistent pulmonary edema on day 2 was the most likely radiological finding.

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Published In

J Crit Care

DOI

EISSN

1557-8615

Publication Date

October 2015

Volume

30

Issue

5

Start / End Page

940 / 944

Location

United States

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Respiration, Artificial
  • Respiration Disorders
  • Oxygen
  • Middle Aged
  • Male
  • Logistic Models
  • Incidence
  • Humans
 

Citation

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Bartz, R. R., Ferreira, R. G., Schroder, J. N., Davies, J., Liu, W.-W., Camara, A., & Welsby, I. J. (2015). Prolonged pulmonary support after cardiac surgery: incidence, risk factors and outcomes: a retrospective cohort study. J Crit Care, 30(5), 940–944. https://doi.org/10.1016/j.jcrc.2015.04.125
Bartz, Raquel R., Renata G. Ferreira, Jacob N. Schroder, John Davies, Wen-Wei Liu, Andre Camara, and Ian J. Welsby. “Prolonged pulmonary support after cardiac surgery: incidence, risk factors and outcomes: a retrospective cohort study.J Crit Care 30, no. 5 (October 2015): 940–44. https://doi.org/10.1016/j.jcrc.2015.04.125.
Bartz RR, Ferreira RG, Schroder JN, Davies J, Liu W-W, Camara A, et al. Prolonged pulmonary support after cardiac surgery: incidence, risk factors and outcomes: a retrospective cohort study. J Crit Care. 2015 Oct;30(5):940–4.
Bartz, Raquel R., et al. “Prolonged pulmonary support after cardiac surgery: incidence, risk factors and outcomes: a retrospective cohort study.J Crit Care, vol. 30, no. 5, Oct. 2015, pp. 940–44. Pubmed, doi:10.1016/j.jcrc.2015.04.125.
Bartz RR, Ferreira RG, Schroder JN, Davies J, Liu W-W, Camara A, Welsby IJ. Prolonged pulmonary support after cardiac surgery: incidence, risk factors and outcomes: a retrospective cohort study. J Crit Care. 2015 Oct;30(5):940–944.
Journal cover image

Published In

J Crit Care

DOI

EISSN

1557-8615

Publication Date

October 2015

Volume

30

Issue

5

Start / End Page

940 / 944

Location

United States

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Respiration, Artificial
  • Respiration Disorders
  • Oxygen
  • Middle Aged
  • Male
  • Logistic Models
  • Incidence
  • Humans