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Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a

Chul Ho Lee1, Jae Seok Jang1, Jun Woo Cho1

  • 1Department of Thoracic and Cardiovascular Surgery, Daegu Catholic University School of Medicine, Daegu, Korea.

Journal of Yeungnam Medical Science
|February 10, 2022
PubMed

Insights

Intensive care unit (ICU) management is not essential for uncomplicated acute type B aortic dissection (ATBAD). Calcium channel blockers may reduce aortic events during follow-up for ATBAD patients.

Area of Science:

  • Cardiovascular Medicine
  • Thoracic Surgery
  • Critical Care Medicine

Background:

  • Medical therapy is standard for acute type B aortic dissection (ATBAD).
  • Evidence supporting intensive care unit (ICU) management for uncomplicated ATBAD is limited.
  • The necessity of ICU treatment for uncomplicated ATBAD requires further investigation.

Purpose of the Study:

  • To evaluate the impact of ICU treatment duration on outcomes in patients with uncomplicated ATBAD.
  • To compare the incidence of complications and long-term survival between patients with short-term versus long-term ICU stays.

Main Methods:

  • Retrospective study of 55 patients with uncomplicated ATBAD treated between 2010 and 2020.
  • Patients categorized into long-term ICU stay (LIS) and short-term ICU stay (SIS) groups based on a 48-hour cutoff.
  • Comparison of pneumonia, delirium, aortic events, mortality, and survival rates between LIS and SIS groups.

Main Results:

  • No statistically significant differences in pneumonia or delirium rates between LIS and SIS groups.
  • Similar 1, 3, and 5-year survival rates for both LIS and SIS groups (p=0.102).
  • Multivariate analysis indicated calcium channel blocker use is associated with a lower risk of aortic events.

Conclusions:

  • Extended ICU stays are likely unnecessary for uncomplicated ATBAD.
  • Active use of antihypertensive medications, specifically calcium channel blockers, may be beneficial during ATBAD follow-up.
  • Further research may refine management protocols for uncomplicated ATBAD.
Abstract

Keywords:
Acute type B aortic dissectionAntihypertensive treatmentIntensive care units

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