RT Journal Article
SR Electronic
T1 Factors Affecting Weaning Failure in Critical Patients with Urgent Gastrointestinal Surgery
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA2281
DO 10.1183/13993003.congress-2019.PA2281
VO 54
IS suppl 63
A1 Fatma Bodur Yildirim
YR 2019
UL http://erj.ersjournals.com/content/54/suppl_63/PA2281.abstract
AB Introduction: Prolonged mechanical ventilation is associated with poor outcomes in surgical patients as well as in medical patients. In this study, the factors affecting the weaning failure of patients who underwent emergent gastrointestinal surgery were examined.Methods: The data of the patients who followed up in the general surgery intensive care unit (ICU) for more than 48 hours during postoperative period between August 2016 and January 2019 were investigated retrospectively.Results: The study included 97 patients with a mean age of 71.8±14.2 years. Sixty-three (64.9%) of the patients were male and 34 (35.1%) were female. The mean APACHE II score was 25.2±6.7. Most common diseases were gastrointestinal malignancy with 72.1%, hypertension with 53.6% and congestive heart failure with 36.1%. The median time of mechanical ventilation was 9 [2-56] days and the mean length of ICU stay was 18.7±12.2 days. Weaning was started median 2 [2-4] days after intubation. The mean weaning time was median 4 [4-8] days. Weaning failure was seen in 80 (82.5%) patients. Of the patients, 21 (21.6%) were simple weaning, 40 (41.2%) were prolonged weaning, and 31 (32.0%) were difficult weaning. Most common reason for weaning difficulty was hypervolemia in 88 (90.7%) patients and postoperative sepsis in 21 (21.6%) patients. Patients with weaning failure had higher lactate levels, erythrocyte suspension and vasopressor requirement, sepsis and acute renal failure. Postoperative lactate elevation (OR:1.345, 95% CI:1.238-2.310, p=0.03), need for vasopressor (OR:1.002, 95%CI:1.018-1.342, p=0.026) and the presence of sepsis (OR:2.034,% 95CI:1.995-3.450, p =0.04) as independent risk factor for weaning failure.FootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA2281.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).