Prolonged use of noninvasive positive pressure ventilation after extubation among patients in the intensive care unit following cardiac surgery: The predictors and its impact on patient outcome

Pei Ku Chen, Chun Che Shih, Fang Chi Lin, Diahn Warng Perng, Kun Ta Chou, Yu Ru Kou, Hsin Kuo Ko

Research output: Contribution to journalArticle

Abstract

This retrospective, observational cohort study aimed to determine the independent risk factors and impact of prolonged non-invasive positive pressure ventilation (NIPPV) after extubation among patients in the intensive care unit following cardiac surgery. Patients who received prophylactic NIPPV after extubation were categorized into prolonged (NIPPV duration >3 days, n = 83) and non-prolonged groups (NIPPV duration ≤3 days, n = 105). The perioperative characteristics and hospital outcomes were recorded. The multivariate analyses identified the preoperative residual volume/total lung capacity (RV/TLC) ratio (adjusted odds ratio [AOR]: 1.10; 95% CI:1.01-1.19, p = 0.022) and postoperative acute kidney injury (AKI) with Kidney Disease Improving Global Outcomes (KDIGO) stage 2-3, 48 h after surgery (AOR: 3.87; 95% CI:1.21-12.37, p = 0.023) as independent predictors of prolonged NIPPV. Patients with both RV/TLC ratio > 46.5% and KDIGO stage 2-3 showed a highly increased risk of prolonged NIPPV (HR 27.17, p = 0.010), which was in turn associated with higher risk of postoperative complications and prolonged ICU and hospital stays. Preoperative RV/TLC ratio and postoperative AKI could identify patients at higher risk for prolonged NIPPV associated with poor outcomes. These findings may allow early recognition of patients who are at a higher risk for prolonged NIPPV, and help refine the perioperative management and critical care.

Original languageEnglish
Number of pages1
JournalScientific Reports
Volume9
Issue number1
DOIs
Publication statusPublished - Jul 2 2019
Externally publishedYes

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Positive-Pressure Respiration
Thoracic Surgery
Intensive Care Units
Total Lung Capacity
Residual Volume
Kidney Diseases
Acute Kidney Injury
Odds Ratio
Perioperative Care
Critical Care
Observational Studies
Length of Stay
Cohort Studies
Multivariate Analysis

ASJC Scopus subject areas

  • General

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Prolonged use of noninvasive positive pressure ventilation after extubation among patients in the intensive care unit following cardiac surgery : The predictors and its impact on patient outcome. / Chen, Pei Ku; Shih, Chun Che; Lin, Fang Chi; Perng, Diahn Warng; Chou, Kun Ta; Kou, Yu Ru; Ko, Hsin Kuo.

In: Scientific Reports, Vol. 9, No. 1, 02.07.2019.

Research output: Contribution to journalArticle

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