Objective To analyze the prognostic factors in the postoperative patients with prolonged mechanical ventilation after extracorporeal circulation.Methods From Oct 2004 to Oct 2007，35 cases of postoperative patients after extracorporeal circulation required mechanical ventilation for ≥24 hours in ICU were enrolled.The patients were divided into death group and survival group.Preoperative variables including blood glucose，serum albumin，creatinine and ejection fraction（EF），intra-operative variables such as cardiopulmonary bypass（CPB） duration，aortic cross clamp（ACC） time，blood transfusion，and postoperative variables such as vital sign arrival at ICU，renal function，drainage in first 24 hours，APACHEⅡ score，ventilation duration were analyzed retrospectively.Results There were significant differences in blood glucose，serum albumin，EF，CPB，ACC，fresh frozen plasma transfusion，APACHEⅡ，creatinine，APTT and oxygenation index between the death group（12 cases，34.29%） and the survival group（23 cases，65.71%）.Stepwise logistic regression analysis indicated that EF（OR=0.7973，95%CI 0.6417-0.9906） and APACHEⅡ（OR=1.8588，95%CI 1.1071-3.1210） were predictors of prognosis.Conclusions High mortality is found in postoperative patients after extracorporeal circulation with prolonged mechanical ventilation.The main predictors of prognosis were EF and APACHEⅡ.It’s important to assess preoperative condition for cardiac surgical patients completely and provide more intensive perioperative care.
Citation：
ZHOU Junfeng,HAN Lili,LI Suwei,WAN Xianyao. Analysis of prognostic factors in postoperative patients with prolonged ventilation after extracorporeal circulation. Chinese Journal of Respiratory and Critical Care Medicine, 2008, 08(5): 330-333. doi:
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- 1. Thompson MJ，Elton RA Sr，Sturgeon KR，et al．The Edinburgh Cardiac Surgery score survival prediction in the long stay ICU cardiac surgical patients.Eur J Cardiothorac Surg，1995，918：419-425.
- 2. Gass GD，Olsen GN．Preoperative pulmonary functional testing to predict postoperative morbidity and mortality．Chest，1986，89：127-175.
- 3. Omato JP，Peberdy MA．Cardiopulmonary Resuscitation.Humana Press Inc，2005，270-584．.
- 4. Hammermeister KE，Burchfiel C，Jolmson R，et al.Identification of patients at great risk for developing major compl ications at cardiac surgery.Circulation，1990，82（S5）：380-389.
- 5. 梁建业.APACHEⅡ与APACHEⅢ在重症监护病房患者中的应用比较.中国危重病急救医学，1995，7：28-30.
- 6. 石应康，主译.胸心外科学.第6版.北京：人民卫生出版社，2000，864-873.
- 7. Natarajan K，Patil S，Lesley N，et al．Predictors of Prolonged Mechanical Ventilation After On-pump Coronary Artery Bypass Grafting.Ann Card Anaesth，2006，9：31-36.
- 8. Hirsch GM，Cha KH，Buth KJ，et al.Independent preoperative predictors of prolonged length of stay following isolated CABG surgery；a prospective multivariate analysis of 1784 patients.Can J Cardiol，1998，14（Suppl）：83F.
- 9. Habib RH，Zacharias A，Engoren M.Determinants of prolonged mechanical ventilation after coronary bypass grafting.Ann Thorac Surg，1996，62：1164-1171.
- 10. Cislaghi F，Condemi AM，Corona A.Predictors of prolonged mechanical ventilation in a cohort of 3，269 CABG patients.Minerva Anestesiol，2007，73：615-621.
