RISK FACTORS DURING CARDIOPULMONARY BYPASS INFLUENCING POSTOPERATIVE MECHANICAL VENTILATION DURATION IN ADULT CARDIAC SURGERY
Keywords:
Prolonged mechanical ventilation, Adult cardiac surgery, Cardiopulmonary bypass, Risk factors, Postoperative pneumonia, Cardioplegia volume, Intensive care stayAbstract
Background: Prolonged mechanical ventilation (PMV) after adult cardiac surgery increases morbidity, mortality, and ICU resource use. While predictors are well-studied in pediatric populations, adult data remain limited. This study aimed to identify risk factors for PMV in adults undergoing cardiac surgery with cardiopulmonary bypass (CPB).
Methods: A prospective study of 85 adult patients undergoing CPB assessed 20 preoperative, intraoperative, and postoperative variables. PMV was defined as mechanical ventilation exceeding 24 hours. Univariate and multivariate logistic regression analyses were performed to determine independent predictors.
Results: Ten patients (11.8%) experienced PMV (median 31 hours vs. 5 hours in non-PMV). Independent risk factors included advanced age (p=0.015), prolonged CPB time (p=0.042), higher cardioplegia volume (p=0.004), postoperative pneumonia (p=0.023), and extended ICU stay (p=0.005).
Conclusion: Advanced age, extended CPB duration, increased cardioplegia volume, postoperative pneumonia, and longer ICU stay significantly elevate the risk of PMV in adult cardiac surgery. Early identification of these factors can guide perioperative management, minimize ventilator dependence, and improve postoperative outcomes.
