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
Artículo
en Inglés
| 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.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Encefalopatías
/
Desconexión del Ventilador
/
Malformaciones Arteriovenosas Intracraneales
/
Extubación Traqueal
Tipo de estudio:
Estudio de etiología
/
Estudio de incidencia
/
Estudio observacional
/
Factores de riesgo
Límite:
Adulto
/
Femenino
/
Humanos
Idioma:
Inglés
Revista:
Braz. j. med. biol. res
Asunto de la revista:
Biologia
/
Medicina
Año:
2011
Tipo del documento:
Artículo
País de afiliación:
Brasil
Institución/País de afiliación:
Santa Casa de Misericórdia de Vitória/BR
/
Universidade Federal de São Paulo/BR
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