Abstract
To evaluate the outcomes of a cohort of prolonged weaning patients after thoracic and cardiac surgery, treated in a specialized weaning centre, we retrospectively analyzed characteristics and outcome of patients consecutively admitted to our regional Weaning Center (WC) since December 2007 to August 2012 (56 months). Among overall 585 patients (337 males, age 70.7±11.7yrs, range 18.8-93.9yrs), 35 patients (17 males; age 73.0±10.1yrs, range 43.4-86.2yrs) after isolated (valve replacement or myocardial revascularization) or combined (both) surgery were also admitted. Twelve patients had undergone emergency surgery; ICU Length of stay had been 56.5±32.0 days. Apache II score at WC admission was 13.5±5.8; SAPS score 35.9±8.6, Charlson score 6.8±2.7, PaO2/FiO2 242.2±88.1. The weaning success rate was 65.7% (23 patients), 20 of them being decannulated. Two patients were transferred to ICU for complications, and 6 patients (17.1%) needed prolonged invasive mechanical ventilation at discharge from WC. The WC length of stay was 26.8±11.3 days, the overall mortality rate was 11.4% (4/35). Lower weaning rate (7/16 vs. 16/19; p=0.03) and a tendence to higher mortality (3/16 vs. 1/19; p= n.s.) were observed in combined surgery group. Survival at 6 months is shown in Figure 1.
These results suggest the usefulness of dedicated weaning centers for difficult-to wean patients undergone cardiac surgery.
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