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

Published

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Bartz, RR; Ferreira, RG; Schroder, JN; Davies, J; Liu, W-W; Camara, A; Welsby, IJ

Published Date

  • October 2015

Published In

Volume / Issue

  • 30 / 5

Start / End Page

  • 940 - 944

PubMed ID

  • 26205187

Pubmed Central ID

  • 26205187

Electronic International Standard Serial Number (EISSN)

  • 1557-8615

Digital Object Identifier (DOI)

  • 10.1016/j.jcrc.2015.04.125

Language

  • eng

Conference Location

  • United States