• Respiratory care · Sep 2019

    Noninvasive Ventilation to Treat Respiratory Failure After Cardiac Surgery: Predictors of Application and Outcome.

    • Fotini Ampatzidou, Afroditi K Boutou, Lampros Karagounis, Nandor Marczin, Apostolos Gogakos, and George Drossos.
    • Cardiothoracic Intensive Care Unit, Cardiac Surgery Department, "G. Papanikolaou" General Hospital, Thessaloniki, Greece. fampatzidou@gmail.com.
    • Respir Care. 2019 Sep 1; 64 (9): 1123-1131.

    BackgroundRespiratory complications remain a major cause of morbidity in cardiac surgery patients. This study aimed to determine the prognostic parameters associated with the application of noninvasive ventilation (NIV) for the treatment of acute respiratory failure, along with the possible predictors associated with NIV failure, among the subjects who underwent cardiac surgery.MethodsThis was a retrospective cohort study. Data on all adult patients who underwent cardiac surgery in a single center between May 2012 and December 2016 were analyzed. Multivariate regression analysis with bootstrapping was used to identify which baseline and intraoperative parameters were associated with the application of NIV to treat acute postoperative respiratory failure. A univariate analysis was also applied to identify potential variables associated with NIV failure. P < .05 was considered significant.ResultsA total of 1,657 subjects (mean ± SD age 65.2 ± 10.7 y; 21.7% females) constituted the study population, 145 (8.8%) of whom were treated with NIV due to acute postoperative respiratory failure. Body mass index adjusted odds ratio 1.02, bias-corrected 95% CI 1.01-1.04), EuroSCORE (European System for Cardiac Operative Risk Evaluation) II (adjusted odds ratio 1.11, bias-corrected 95% CI 1.02-1.32), COPD (adjusted odds ratio 4.004, bias-corrected 95% CI 2.53-8.93), and preoperative estimated glomerular filtration rate (adjusted odds ratio 0.99, bias-corrected 95% CI 0.98-0.99) independently predicted NIV application. NIV treatment failed in 16 of the 145 subjects (11%) and age, EuroSCORE II, COPD, heart failure, renal replacement therapy, and postoperative stroke were all univariately associated with the outcome.ConclusionsNIV successfully treated acute respiratory failure in the vast majority of cardiac surgery subjects and COPD, EuroSCORE II, body mass index, and preoperative renal function were independently associated with its application.Copyright © 2019 by Daedalus Enterprises.

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