Risk factors of delayed extubation after cardiac valvular replacement surgery

Objective To investigate the risk factors of delayed extubation undergoing cardiac valvular surgery in ICU and to provide base for effective control measure.Methods Case-control study was performed on 77 patients who undergone cadiac vavular surgery from January 2008 to September 2012 in the People's Hospital of Three Gorge University.Among the patients,19 cases with mechanical ventilation time ＞ 48 h or repeat endotracheal intubation were selected as case group and the other 58 patients were as our control group.Multivariable logistic regression analysis was adopted to analyze the potential risk factors.Results Of all patients,19 patients were with prolonged mechanical ventilation,and the rate of delayed extubation was 24.67％ (19/77).Univariate analysis of risk factors showed that preoperative renal damage(x2 =12.396,P =0.000),postoperative renal damage (x2 =4.398,P =0.036),age≥50 year(x2 =12.788,P =0.000),gender(female) (x2 =5.416,P =0.020) and blood purification (x2 =15.374,P =0.000) were the risk factors of delayed extubation undergoing cardiac valvular surgery.Multivariable logistic regression analysis indicated that blood purification (OR =15.890,95％ CI =1.432-176.295,P ＜ 0.05) and preoperative renal failure (OR =8.536,95 ％ CI =1.059-68.786,P ＜ 0.05) were the independent risk factors.Conclusion Preoperative renal dysfunction is the independent risk factors of delayed extubation undergoing cardiac valvular surgery. Key words: Heart valve prosthesis implantation;  Delayed extubation;  Risk factor