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学科主题: 临床医学
题名:
Myocardial Injury after Surgery Is a Risk Factor for Weaning Failure from Mechanical Ventilation in Critical Patients Undergoing Major Abdominal Surgery
作者: Li, Shu1; An, You-zhong1; Ren, Jing-yi2; Zhu, Feng-xue1; Chen, Hong2
刊名: PLOS ONE
发表日期: 2014-11-19
DOI: 10.1371/journal.pone.0113410
卷: 9, 期:11
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Multidisciplinary Sciences
研究领域[WOS]: Science & Technology - Other Topics
关键词[WOS]: NONINVASIVE VENTILATION ; NONCARDIAC SURGERY ; CARDIAC-SURGERY ; METAANALYSIS ; OUTCOMES ; CARE
英文摘要:

Background: Myocardial injury after noncardiac surgery (MINS) is a newly proposed concept that is common among adults undergoing noncardiac surgery and associated with substantial mortality. We analyzed whether MINS was a risk factor for weaning failure in critical patients who underwent major abdominal surgery.

Methods: This retrospective study was conducted in the Department of Critical Care Medicine of Peking University People′s Hospital. The subjects were all critically ill patients who underwent major abdominal surgery between January 2011 and December 2013. Clinical and laboratory parameters during the perioperative period were investigated. Backward stepwise regression analysis was performed to evaluate MINS relative to the rate of weaning failure. Age, hypertension, chronic renal disease, left ventricular ejection fraction before surgery, Acute Physiologic and Chronic Health Evaluation II score, pleural effusion, pneumonia, acute kidney injury, duration of mechanical ventilation before weaning and the level of albumin after surgery were treated as independent variables.

Results: This study included 381 patients, of whom 274 were successfully weaned. MINS was observed in 42.0% of the patients. The MINS incidence was significantly higher in patients who failed to be weaned compared to patients who were successfully weaned (56.1% versus 36.5%; P < 0.001). Independent predictive factors of weaning failure were MINS, age, lower left ventricular ejection fraction before surgery and lower serum albumin level after surgery. The MINS odds ratio was 4.098 (95% confidence interval, 1.07 to 15.6; P = 0.04). The patients who were successfully weaned had shorter hospital stay lengths and a higher survival rate than those who failed to be weaned.

Conclusion: MINS is a risk factor for weaning failure from mechanical ventilation in critical patients who have undergone major abdominal surgery, independent of age, lower left ventricular ejection fraction before surgery and lower serum albumin levels after surgery.

语种: 英语
WOS记录号: WOS:000345533200114
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/60470
Appears in Collections:北京大学第二临床医学院_重症医学科_期刊论文

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作者单位: 1.Peking Univ, Peoples Hosp, Dept Crit Care Med, Beijing 100871, Peoples R China
2.Peking Univ, Peoples Hosp, Dept Cardiol, Beijing 100871, Peoples R China

Recommended Citation:
Li, Shu,An, You-zhong,Ren, Jing-yi,et al. Myocardial Injury after Surgery Is a Risk Factor for Weaning Failure from Mechanical Ventilation in Critical Patients Undergoing Major Abdominal Surgery[J]. PLOS ONE,2014,9(11).
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