Indices predictores del retiro precoz de ventilación mecánica en pacientes sometidos a cirugía cardíaca / Predictor rates of early mechanical ventilation withdrawal in patients submitted to cardiac surgery

ABSTRACT

To study the capacity to predict successful early extubation of ventilatory and gas exchange parameters, 230 patients admitted to an intensive care unit after coronary or valvular surgery were studied. Measurements were made through a T piece 30 minutes after discontinuing mechanical ventilation. Six patients died in the postoperative period. Two hundred ten patients tolerated early extubation (14ñ5 h of mechanical ventilation) and 20 required prolonged mechanical ventilation (74ñ107 h). The latter had longer surgical procedures (291ñ65 and 240ñ67 min respectively) and extracorporeal circulation times (138ñ42 and 104ñ43 min respectively), required more vasoactive drugs, had more episodes of confusion and had a higher surgical risk. Tidal volume, respiratory frequency, maximal inspiratory pressure and blood gases at the moment of extubation were similar in both groups. Pulmonary function parameters and blood gases measured during a T piece trial are not good predictors of early extubation in cardiac surgery