Predictors of Weaning Failure from Mechanical Ventilation in Post Cardiac Surgery Patients

Abstract

Abstract Background Cardiac surgery disrupts homeostasis, putting the patient in danger. Weaning from a ventilator requires clinical judgement and multiple signs. Patients recovering from anaesthesia can restart spontaneous ventilation. Cardiopulmonary bypass recovers during breathing. Weaning patients from mechanical ventilation after heart surgery involves vital capacity, tidal volume, respiratory rate, and minute ventilation. Others have related advanced age, comorbidities, protracted extracorporeal circulation, cardiac dysfunction, and low cardiac output to unsuccessful weaning of cardiac patients from mechanical ventilation and postoperative hemodynamics and neurological alterations to long-term ventilation. Aim To determine predictors of unsuccessful weaning from mechanical ventilation after cardiac surgery, and therefore avoid the potentially hazardous long stay in ICU. Subjects and Methods This study was conducted at Ain Shams University Hospital, post cardiac surgery ICU including 80 patients undergo cardiac surgery and receiving mechanical ventilation after operation. Results Most of our included patients were successfully extubated. Most of our included patients developed intraoperative complications; the commonest complications were pacemaker wire followed by VF. Most of our included patients have CABG followed by MVR. Most of our included patients have mild tracheal secretion followed by moderate secretion. Charlson Comorbidity Index, COPD and CVS were statistically significant higher in failed extubation than weaned group while MBP and PO2/FIO2were statistically significant lower in failed than weaned patients. Conclusion From findings of this study we can conclude that SOFA (≥ 6), Comorbidity index (>3), sever tracheal Secretion, RR/TV (≥57), MV (≥ 13.5) are independent predictors of failed weaning from mechanical ventilation.