Table 1.
Most recent studies on perioperative risk factors for prolonged mechanical ventilation following cardiac surgery.
| Author, Year, Reference | Patients | Preoperative Risk Factors | Intra/Postoperative Risk Factors | Protective Factors |
|---|---|---|---|---|
| Totonchi et al., 2014 [12] | 743 consecutive CPB patients | female sex, hypertension, COPD, CKD | endocarditis surgery, bleeding, inotrope dependency | isolated CABG, duration of surgery <4 h, CPB < 60 min |
| Murthy et al., 2007 [13] | 12,777 consecutive cardiovascular patients (excluding HTX and VAD) | BMI, NYHA class, COPD | aortic surgery, CPB time, bleeding, inotrope dependency, low cardiac index, early postoperative complications * | |
| Nozawa et al., 2005, [14] | 52 patients on prolonged ventilation (mean 10 days) after CPB surgery. † | cardiac complications ‡, RRT, inotrope dependency | ||
| Cislaghi et al., 2007, [15] | 3269 on-pump CABG patients | LVEF < 30% | re-do surgery, CPB > 90 min, PRBC transfusion, FFP transfusion | |
| Reddy et al., 2007, [16] | 12,662 consecutive cardiac surgery patients (both on- and off-pump) | age, FEV1 < 70%, current smoker, serum creatinine, peripheral vascular disease, LVEF < 30%, recent MI, preoperative ventilation | re-do surgery, urgent-emergent surgery, mitral valve surgery, aortic surgery, use of CPB | |
| Wang et al., 2022, [19] | 5323 CPB patients | age, renal failure, DM, COPD, preoperative pulmonary oedema | combined CABG + valvular surgery, aortic surgery, emergent surgery |
* Stroke, bacteremia, sepsis, or reoperation for bleeding occurring < 72h from surgery. † Study evaluated risk factors for weaning failure from prolonged ventilation. ‡ Low cardiac output syndrome, bleeding, arrhythmias, or cardiac arrest. BMI, body mass index; CABG, coronary artery bypass graft; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; CPB, cardiopulmonary bypass; DM, diabetes mellitus; FEV1, first second forced expired volume; FFP, fresh frozen plasma; LVEF, left ventricular ejection fraction; MI, myocardial infarction; NYHA, New York Heart Association; PRBC, packed red blood cells; RRT, renal replacement therapy; VAD, ventricular assist device.