Factors Associated with Intubation Time and ICU Stay After CABG

ABSTRACT OBJECTIVE: The aim of this study was to identify factors associated with intubation time and intensive care unit stay after coronary artery bypass grafting with cardiopulmonary bypass. METHODS: This was a retrospective study, whose data collection was performed in the hospital charts of 160 patients over 18 years, who underwent surgery from September 2009 to July of 2013 in a hospital in the state of Espirito Santo, Brazil. RESULTS: The mean age of the subjects was 61.44±8.93 years old and 68.8% were male. Subjects had a mean of 5.17±8.42 days of intensive care unit stay and mean intubation time of 10.99±8.41 hours. We observed statistically significant positive correlation between the following variables: patients' age and intubation time; patients' age and intensive care unit stay; intubation time and intensive care unit stay. CONCLUSION: In conclusion, the study showed that older patients had longer intubation time and increased intensive care unit stay. Furthermore, patients with longer intubation time had increased intensive care unit stay.

Tracheal stenosis after intubation and/or tracheostomy

The tracheal iatrogenic stenosis remains a frequent, sometimes severe tracheal resection, anastomosis is the treatment of choice. However, the endoscopic treatment is used as an alternative therapy. We report a retrospective study for a period of 8 years. 174 patients had an iatrogenic tracheal stenosis of intubation [55.17%] and/or tracheotomy [44.82%]. The appearance and extent of stenosis were assessed by bronchoscopy, we noted a tracheal mala-cia [15%], a circumferential stenosis [58%], a little tight stenosis [12%] and diaphragm [5%]. Some patients have benefited from several therapeutic procedures, 90 patients were operated on early interventions with 53 and 37 after surgery, an improvement of the patient's clinical status have been postponed earlier, after failure of endoscopic methods. 293 interventional bronchoscopies were performed, 192 stenting, 45 Nd-YAG laser, 55 patients required a recalibration in the tube of the bronchoscope and one patient received cryotherapy, knowing that there are the patients who received combination therapy. We lamented death in the immediate postoperative sepsis, a recurrence of stenosis in 117 patients, and among the 192 implants placed we identified 37 migrations, 52 congestion, development of granulomatous lesions, an overhaul of the prosthesis is noted in 7.29%, three implants were embedded in the tracheal mucosa and there was only one spontaneous rejection. The long-term evolution was satisfactory in 92 patients. Nevertheless, the management of post intubation tracheal stenosis and/or post tracheostomy cannot be that requiring a multidisciplinary collaboration