Implications of extubation failure and prolonged mechanical ventilation in the postoperative period following elective intracranial surgery
Braz. j. med. biol. res
;
44(12): 1291-1298, Dec. 2011. tab
Article
in English
| LILACS
| ID: lil-606545
ABSTRACT
Patients undergoing neurosurgery are predisposed to a variety of complications related to mechanical ventilation (MV). There is an increased incidence of extubation failure, pneumonia, and prolonged MV among such patients. The aim of the present study was to assess the influence of extubation failure and prolonged MV on the following variables postoperative pulmonary complications (PPC), mortality, reoperation, tracheostomy, and duration of postoperative hospitalization following elective intra-cranial surgery. The study involved a prospective observational cohort of 317 patients submitted to elective intracranial surgery for tumors, aneurysms and arteriovenous malformation. Preoperative assessment was performed and patients were followed up for the determination of extubation failure and prolonged MV (>48 h) until discharge from the hospital or death. The occurrence of PPC, incidence of death, the need for reoperation and tracheostomy, and the length of hospitalization were assessed during the postoperative period. Twenty-six patients (8.2 percent) experienced extubation failure and 30 (9.5 percent) needed prolonged MV after surgery. Multivariate analysis showed that extubation failure was significant for the occurrence of death (OR = 8.05 [1.88; 34.36]), PPC (OR = 11.18 [2.27; 55.02]) and tracheostomy (OR = 7.8 [1.12; 55.07]). Prolonged MV was significant only for the occurrence of PPC (OR = 4.87 [1.3; 18.18]). Elective intracranial surgery patients who experienced extubation failure or required prolonged MV had a higher incidence of PPC, reoperation and tracheostomy and required a longer period of time in the ICU. Level of consciousness and extubation failure were associated with death and PPC. Patients who required prolonged MV had a higher incidence of extubation failure.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Brain Diseases
/
Ventilator Weaning
/
Intracranial Arteriovenous Malformations
/
Airway Extubation
Type of study:
Etiology study
/
Incidence study
/
Observational study
/
Risk factors
Limits:
Adult
/
Female
/
Humans
Language:
English
Journal:
Braz. j. med. biol. res
Journal subject:
Biology
/
Medicine
Year:
2011
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Santa Casa de Misericórdia de Vitória/BR
/
Universidade Federal de São Paulo/BR
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