Original articlePostoperative Respiratory Failure After Cardiac Surgery: Use of Noninvasive Ventilation
Section snippets
Methods
This observational study was conducted in a university hospital ICU to which all adult cardiac surgical patients are transferred from the operating room. The hospital has 1,200 beds and serves a population of 450,000 inhabitants, and the ICU has 42 beds and admits about 2,000 patients annually, of whom around 400 are postoperative cardiac surgical patients. Data were gathered retrospectively on patients admitted from September 2006 through September 2009 from the computerized ICU patient
Results
Of 1,225 patients admitted to the ICU after cardiac surgery during the 3-year study period, 63 (5.1%) were treated with NIV for respiratory failure after the first extubation (Fig 1). Table 1 presents the baseline characteristics and histories of these patients.
In the postoperative unit, the median duration of the initial MV (from surgery to extubation) was 8 hours (range, 5-24 hours) for all patients. In contrast, the median time of the initial MV was 38 hours (range, 8-211 hours) and the
Discussion
The main findings of the present study were that reintubation was necessary for around 50% of postoperative cardiac surgical patients treated with NIV for respiratory failure after extubation and that NIV failure was associated with an increased mortality rate. The early onset (<24 hours) of respiratory failure after extubation was associated with NIV failure, and obesity was associated with NIV success.
Reported NIV failure rates vary and depend on multiple factors, such as the experience of
Acknowledgments
The authors are grateful to Richard Davies for assistance with the English version of this report.
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