Aurika Karbonskienė, Darius Kuzminskis, Artūras Plioraitis, Jurgita Kuzminskienė
The aim of the research: to find out predictors of the prolonged mechanical ventilation after emergency surgery.
Methodology: retrospective review of case – histories of all adult patients in whom emergency surgery was performed in a single non – cardiac surgery unit of tertiary care hospital in 2010. Primary endpoint studied was severe respiratory complication defined as respiratory insufficiency requiring intubation and transfer to an intensive care unit for mechanical ventilatory support. Demographics, pre-, intra- and postoperative data, duration of mechanical ventilation (MV) and outcomes of mechanically ventilated patients were evaluated. Statistical analysis was made using SPSS 18.0. We used Student‘s criterion, Mann – Whitney, Kruskal – Wallis and Wilcoxon‘s tests where appropriate. Level of significance – p<0,05.
Results: 210 cases of postoperative MV were identified (duration 31,5 ± 52,6 h). Duration of MV depended on preoperative factors: ASA class (p=0,000), presence of ischaemic heart disease (p=0,045), anaemia (p=0,003), elevated serum nitrogen (p=0,030), preoperative MV (p=0,000); postoperative events: arrhythmias (p=0,008), infection (p=0,000), acute renal failure (p=0,011), shock (p=0,000). We could not find statistically significant dependence between duration of mechanical ventilation and lung diseases (p=0,000), oncological diseases (p=0,090), hae�- motransfusion (p=0,099). Risk of lethal outcome was increased in case of MV (p=0,000).
Conclusions: we identified multiple risk factors that have an effect on the development of acute respiratory failure after emergency surgery. Early and aggressive intervention in case of infection may contribute to a better outcome.
Keyword(s): mechanical ventilation; predictive factors; emergency surgery
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