Association Between Early Extubation and Postoperative Reintubation After Elective Cardiac Surgery: A Bi-institutional Study
| Autor: | Kara G. Fields, Ethan Y. Brovman, J. Daniel Muehlschlegel, Gaston A. Cudemis Deseda, Tsuyoshi Kaneko, George Tolis, Andrea L. Axtell, Sameer A. Hirji, Richard D. Urman, Sergey Karamnov |
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| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Logistic regression Tertiary care Aortic valve replacement Risk Factors Humans Medicine Cardiac Surgical Procedures Coronary Artery Bypass Post operative Risk factor Retrospective Studies Heart Valve Prosthesis Implantation business.industry medicine.disease Surgery Cardiac surgery Treatment Outcome Anesthesiology and Pain Medicine medicine.anatomical_structure Aortic Valve Airway Extubation Observational study Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | Journal of Cardiothoracic and Vascular Anesthesia. 36:1258-1264 |
| ISSN: | 1053-0770 |
| Popis: | Objective It is unknown if remaining intubated after cardiac surgery is associated with a decreased risk of postoperative reintubation. The primary objective of this study was to investigate whether there is an association between the timing of extubation and the risk of reintubation after cardiac surgery. Design A retrospective, observational study. Setting Two university affiliated tertiary care centers. Participants 9,517 patients undergoing either isolated coronary artery bypass grafting (CABG) or aortic valve replacement (AVR). Intervention None Measurements and Main Results A total of 6,609 isolated CABGs and 2,908 isolated AVRs were performed during the study period. Reintubation occurred in 112 patients (1.64%) after CABG and 44 patients (1.5%) after AVR. After multivariable logistic regression analysis, early extubation (within the first 6 post-operative hours) was not associated with risk of reintubation after CABG (OR 0.53, 95% CI 0.26-1.06) and AVR (OR 0.52, 95% CI 0.22-1.22). Risk factors for reintubation included increased age in both the CABG (OR per 10 year increase, 1.63; 95% CI, 1.28-2.08) and AVR (OR per 10 year increase, 1.50; 95% CI, 1.12-2.01) cohorts. Total bypass time, race, and New York Heart Association (NYHA) functional class were not associated with reintubation risk. Conclusion Reintubation after CABGs and AVRs is a rare event, and advanced age is an independent risk factor. Risk is not increased with early extubation. This temporal association and low overall rate of reintubation suggest the strategies for extubation should be modified in this patient population. |
| Databáze: | OpenAIRE |
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