TY  - JOUR
TI  - Predictors of postoperative prolonged mechanical ventilation after left ventricular assist device surgery
AB  - Aim: Prolonged mechanical ventilation (PMV) after cardiovascular surgeries is associated with morbidity and mortality. The aim ofthe study was to determine the risk factors for postoperative PMV (PPMV) after left ventricular assist device (LVAD) surgery.Material and Methods: We retrospectively analyzed the data of patients who underwent LVAD surgery between 2011 and 2016.Prolonged mechanical ventilation was defined as postoperative tracheal extubation 24 hours after the patient is admitted to the ICU.Patients were divided into two groups whether they were extubated within 24 hours of surgery or extubated after 24 hours followingsurgery.Results: During the study period, a total of fifty-seven patients were admitted to ICU. Fifty-seven patients’ data were screened. Themean age of the 57 patients enrolled was 44.6 ± 16.1 years. Of them, 82% were male, and 54 (95%) patients had dilated cardiomyopathydiagnosis. A total of 26 (46%) patients required PPMV. The two groups were similar in terms of demographics, duration of surgery,postoperative LVAD flow rates, presence of preoperative MV, infections, and circulatory support devices (p > 0.05). Patients whorequired PPMV underwent more revision surgeries [14 (54%) vs. 2 (7%), p < 0.001] and had higher incidences of acute kidney injury(AKI) on the first day after the surgery [13 (50%) vs. 4 (13%), p = 0.003] compared with those who did not require PPMV. Furthermore,the patients who required PPMV also required more renal replacement therapies postoperatively [12 (46%) vs. 5 (16%), p = 0.02] andhad longer intensive care unit stay (30.1±25.2 days vs. 14.0 ±11.4 days, p = 0.002) and had higher hospital mortality (58% vs. 35%, p= 0.043) and 30-day mortality (38% vs. 16%, p = 0.042) than those who did not require PPMV. Logistic regression analysis revealedpostoperative AKI as an independent risk factor for PPMV (OR = 0.223, 95% CI 0.067–0.743, p = 0.015).Conclusion: Our results revealed that almost half of the patients who underwent LVAD surgery required PPMV. AKI on the first dayfollowing surgery is an independent risk factor for PPMV.
AU  - Güner, Funda
AU  - Ozdemirkan, Aycan
AU  - Zeyneloglu, Pinar
AU  - SEZGİN, atilla
AU  - Sahinturk, Helin
AU  - Pirat, Arash
DO  - 10.5455/annalsmedres.2020.12.820
PY  - 2020
JO  - Annals of Medical Research
VL  - 27
IS  - 2
SN  - 2636-7688
SP  - 604
EP  - 611
DB  - TRDizin
UR  - http://search/yayin/detay/365439
ER  -