Extubation failure in operating room: Review of management in 50 patients at a single center

Abstract

Aim: Postoperative extubation failure is a serious complication of general anesthesia. Prolonged mechanical ventilation is associated with increased morbidity and late mortality. There are numerous factors affecting postoperative extubation failure. In our study, we aimed to evaluate these factors.

Methods: This retrospective cohort study was conducted on 50 patients who could not be extubated postoperatively between January 2016 and January 2019 in Medipol University Medical Faculty Hospital. 

Results: The mean age was 61.2 (6.4) (50-77) years. 29 (58%) patients were male and 21 (42%) were female. The mean Body Mass Index was 29.3 (3.6) (12-36) kilogram/square meters (kg/m2). Mean duration of surgery was 240 (27.6) minutes. 39 (78%) patients had chronic obstructive pulmonary disease and 13 (26%) had congestive heart failure. Perioperative oxygen saturation was ≤95% in 44 (88%) patients and >95% in 6 (12%) patients. 

Conclusions: Chronic obstructive pulmonary diseases, congestive heart failure and low perioperative oxygen saturation are commonly seen in patients who could not be weaned from mechanical ventilation postoperatively. We advise watching out for patients with these risk factors.

Keywords

• Extubation,Chronic obstructive pulmonary disease,Congestive heart failure,Perioperative oxygen saturation

Ameliyat sonrası ekstübe edilemeyen hastalar: Tek merkezde 50 vakanın incelenmesi

Öz

Amaç: Ameliyat sonrası ekstübe edilemeyen hastalar genel anestezi için ciddi bir durumdur. Uzun süreli mekanik ventilasyon artmış morbidite ve geç mortalite ile ilişkilidir. Ameliyat sonrası ekstübe edilememeyi etkileyen birçok faktör vardır. Çalışmamızda, bu faktörleri araştırdık.

Yöntemler: Bu retrospektif kohort çalışma, Ocak 2016 - Ocak 2019 tarihleri arasında Medipol Üniversitesi Tıp Fakültesi Hastanesi’nde ameliyat sonrası ekstübe edilemeyen 50 hasta üzerinde yapıldı. 

Bulgular: Yaş ortalaması 61,2 (6,4) (50-77) yıldı. 29 (%58) hasta erkek, 21 (%42) hasta kadındı. Ortalama Vücut Kitle İndeksi 29,3 (3,6) (12-36) kilogram / metrekare (kg/m2), ortalama ameliyat süresi 240 (27,6) dakikaydı. Kronik obstrüktif akciğer hastalığı olan 39 (%78) hasta, konjestif kalp yetmezliği olan 13 (% 26) hasta vardı. Perioperatif oksijen satürasyonu 44 (%88) hastada ≤%95 ve 6 (%12) hastada >%95 idi.

Sonuçlar: Ameliyat sonrası ekstübe edilemeyen hastalarda kronik obstrüktif akciğer hastalıkları, konjestif kalp yetmezliği ve düşük perioperatif oksijen satürasyonu sıklıkla görülmektedir. Bu hastaların yönetiminde daha dikkatli olunması gerektiğini düşünüyoruz.

Anahtar Kelimeler

• Ekstübasyon,Kronik obstrüktif akciğer hastalığı,Konjestif kalp yetmezliği,Perioperatif oksijen satürasyonu

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