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Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Factors associated with extubation time in coronary artery bypass grafting patients
Abbas Rezaianzadeh1, Behzad Maghsoudi2, Hamidreza Tabatabaee3
1Colorectal Research Center, Department of epidemiology, School of Health, Shiraz University of Medical Sciences , Shiraz , Iran.
Insights
Predictors of extubation time after Coronary Artery Bypass Grafting (CABG) surgery were identified. Post-operative factors significantly influenced extubation duration, impacting patient recovery and hospital stay.
Area of Science:
- Cardiology
- Thoracic Surgery
- Critical Care Medicine
Background:
- Cardiovascular diseases, particularly coronary artery disease, are leading global causes of mortality.
- Coronary Artery Bypass Grafting (CABG) is a prevalent surgical procedure worldwide.
- Respiratory disorders and prolonged mechanical ventilation are significant post-CABG complications.
Purpose of the Study:
- To identify key predictors of extubation time in patients undergoing CABG surgery.
- To analyze the influence of pre-operative, peri-operative, and post-operative variables on extubation duration.
- To utilize casualty network analysis for understanding the complex factors affecting post-CABG recovery.
Main Methods:
- A longitudinal study involving 800 adult patients who underwent CABG.
- Retrospective extraction of patient data from medical records.
- Path analysis using MPLUS-7.1 software for comprehensive data analysis.
Main Results:
- The average extubation time was 10.27 ± 4.39 hours.
- Significant predictors of extubation time included: packed red blood cells (during and after cardiopulmonary bypass, and in ICU), inotrope use on ICU arrival, mean arterial pressure in ICU, platelet count in ICU, Blood Urea Nitrogen in ICU, and hematocrit in ICU.
- Both peri-operative and post-operative factors demonstrated significant effects on extubation time.
Conclusions:
- Peri-operative and post-operative factors significantly impact extubation time in CABG patients.
- Post-operative variables are crucial for developing effective treatment plans and predicting patient prognosis.
- Understanding these predictors can help optimize patient management and reduce complications.
Abstract:
Background and Objectives. Cardiovascular diseases are the leading cause of death worldwide, with coronary artery disease being the most common. With increasing numbers of patients, Coronary Artery Bypass Grafting (CABG) has become the most common operation in the world. Respiratory disorder is one of the most prevalent complications of CABG. Thus, weaning off the mechanical ventilation and extubation are of great clinical importance for these patients. Some post-operative problems also relate to the tracheal tube and mechanical ventilation. Therefore, an increase in this leads to an increase in the number of complications, length of hospital stay, and treatment costs. Since a large number of factors affect the post-operative period, the present study aims to identify the predictors of extubation time in CABG patients using casualty network analysis. Method. This longitudinal study was conducted on 800 over 18 year old patients who had undergone CABG surgery in three treatment centers affiliated to Shiraz University of Medical Sciences. The patients' information, including pre-operative, peri-operative, and post-operative variables, was retrospectively extracted from their medical records. Then, the data was comprehensively analyzed through path analysis using MPLUS-7.1 software. Results. The mean of extubation time was 10.27 + 4.39 h. Moreover, extubation time was significantly affected by packed cells during the Cardiopulmonary Bypass (CPB), packed cells after CPB, inotrope use on arrival at ICU, mean arterial pressure 1st ICU, packed cells 1st ICU, platelets 1st ICU, Blood Urea Nitrogen 1st ICU, and hematocrit 1st ICU. Conclusion. Considering all of the factors under investigation, some peri-operative and post-operative factors had significant effects. Therefore, considering the post-operative factors is important for designing a treatment plan and evaluating patients' prognosis.
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