011. Predictive factors of noninvasive ventilation failure in postoperative cardiac surgery patients
The Pan Hellenic Congress Abstracts

011. Predictive factors of noninvasive ventilation failure in postoperative cardiac surgery patients

Fotini Ampatzidou1, Lampros Karagounis2, Maria Sileli1, George Kechagioglou1, Theodoros Karaiskos1, Athanasios Madesis1, Antonios Baddour1, Sokratis Tsagkaropoulos1, Geore Drossos1

1Department of Cardiothoracic Surgery, General Hospital ‘G. Papanikolaou’, Thessaloniki, Greece; 2Interventional Cardiology Department, Interbalkan European Medical Center, Thessaloniki, Greece

Background: Noninvasive Ventilation (ΝΙV) is an important therapeutic choice in case of acute respiratory failure after cardiac surgery with cardiopulmonary bypass. Aim of our retrospective study is to investigate factors associated with ΝΙV failure resulting in re-intubation.

Methods: A total of 751 patients (590 males and 161 females) underwent cardiac surgical procedures in our Cardiothoracic Department between June 2012 to March 2014. Our study population consists of 113 patients who experienced postoperative respiratory complications managed by application of NIV. The need of early re-intubation represents the definition of NIV failure. A total of 11 patients from the study group failed and were re-intubated—Group A—while the rest 102 patients consist the group B. A total of 24 perioperative factors were compared between the two groups. Statistical analysis based on univariate and multivariate regression analysis tests.

Results: Univariate test revealed statistical significance (P< 0.05) for 10 of the total perioperative control factors: Euroscore (predictive score), red blood transfusions, duration of mechanical ventilation, chronic obstructive pulmonary disease (COPD), postoperative pneumonia, cardiopulmonary bypass time (CPB Time), preoperative renal function (based on EGFR), dialysis therapy for renal failure, multiple organ dysfunction syndrome (MODS) and acute kidney injury (AKI). These 10 factors were included in stepwise multiple regression analysis which revealed the following four NIV failure factors in cardiac surgery patients with acute respiratory failure: 1/cardiopulmonary bypass Time 2/postoperative pneumonia 3/dialysis therapy for renal failure 4/postoperative MODS.

Conclusions: Recognition of NIV failure factors in postoperative cardiac surgery patients with acute respiratory failure, may contribute to earlier and proper decision about re-intubation, taking into account that delayed intubation is associated with increased morbidity and mortality rates.

Keywords: Noninvasive ventilation; surgery; infection

doi: 10.3978/j.issn.2072-1439.2015.AB011

Cite this abstract as: Ampatzidou F, Karagounis L, Sileli M, Kechagioglou G, Karaiskos T, Madesis A, Baddour A, Tsagkaropoulos S, Drossos G. Predictive factors of noninvasive ventilation failure in postoperative cardiac surgery patients. J Thorac Dis 2015;7(S1):AB011. doi: 10.3978/j.issn.2072-1439.2015.AB011

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