Risk Factors for Prolonged Mechanical Ventilation Following Surgery for Acute Type A Aortic Dissection
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概要
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Background The aim of this study was to identify predictors of prolonged mechanical ventilation (PMV) following surgery for acute type,A aortic dissection (AAAD) and to assess the influence of this complication on clinical outcomes. Methods and Results A total of 243 patients underwent emergency surgery for AAAD in the period of 1997-2006. Ten patients died within 48h after surgery. The remaining 233 patients were divided into 2 groups according to the duration of mechanical ventilation; less than 48h (group A: n=149) or 48h or longer (group B; n=84). Multivariate analysis was used to identify predictors of PMV. Short and late outcomes were compared between groups. Multivariate analysis showed that shock (systolic BP<90mmHg; p=0.007), postoperative renal dysfunction (creatinine >2.0mg/dl; p=0.016), coronary artery bypass grafting (CABG) (p=0.017), and limb ischemia (p=0.044) were independent predictors of PMV. There was no significant difference in in-hospital mortality (group A, 2.7% vs group B, 3.6%) or 5-year survival (group A, 85.9% vs group B, 76.8%). Conclusions Shock, limb ischemia, CABG, and postoperative renal dysfunction increase the risk for PMV. Knowing the predictors of PMV should help optimize postoperative management of these patients.
- 社団法人日本循環器学会の論文
- 2008-10-20
著者
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Yamaguchi Atsushi
Department Of Cardiovascular Surgery Saitama Medical Center Jichi Medical University
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TANAKA Masashi
Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University
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ADACHI Hideo
Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University
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Ishida Takeshi
自治医科大学附属大宮医療センター
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KAWAHITO Koji
Department of Thoracic and Cardiovascular Surgery, Jichi Medical School
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KIMURA Naoyuki
Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University
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INO Takashi
Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University
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Ino Takashi
Department Of Cardiovascular Surgery Saitama Medical Center Jichi Medical University
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Ino Takashi
Department Of Cardiovascular Surgery Mitsui Memorial Hospital
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Adachi Hideo
Department Of Cardiovascular Surgery Saitama Medical Center Jichi Medical University
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Kawahito Koji
Department Of Cardiac Surgery Kashiwa Hospital Jikei University School Of Medicine
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SANUI Masamitsu
Department of Anesthesiology and Critical Care Medicine, Saitama Medical Center, Jichi Medical Unive
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Tanaka Masashi
Department Of Cardiovascular Surgery Saitama Medical Center Jichi Medical University
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Kimura Naoyuki
Department Of Cardiovascular Surgery Itabashi Chuo Medical Center
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Adachi Hideo
Department Of Cardiovascular Surgery And Department Of Radiology Omiya Medical Center Jichi Medical
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Tanaka Masashi
Department Of Cardiology Hamamatsu Rosai Hospital
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Kawahito Koji
Department Of Cardiac Surgery Jikei University Kashiwa Hospital
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Sanui Masamitsu
Department Of Anesthesiology And Critical Care Medicine Saitama Medical Center Jichi Medical Univers
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Sanui Masamitsu
Department Of Anesthesiology And Critical Care Jichi Medical University Saitama Medical Center
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TANAKA Masashi
Department of Biology, Faculty of Science, Tokyo Metropolitan University
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