Implications of extubation failure and prolonged mechanical ventilation in the postoperative period following elective intracranial surgery

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dc.contributor.authorVidotto, Milena Carlos [UNIFESP]
dc.contributor.authorSogame, Luciana Carrupt Machado [UNIFESP]
dc.contributor.authorGazzotti, Mariana Rodrigues [UNIFESP]
dc.contributor.authorPrandini, Mirto Nelso [UNIFESP]
dc.contributor.authorJardim, José Roberto [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionSanta Casa de Misericórdia de Vitória Escola Superior de Ciências Departamento de Fisioterapia
dc.date.accessioned2015-06-14T13:43:26Z
dc.date.available2015-06-14T13:43:26Z
dc.date.issued2011-12-01
dc.description.abstractPatients undergoing neurosurgery are predisposed to a variety of complications related to mechanical ventilation (MV). There is an increased incidence of extubation failure, pneumonia, and prolonged MV among such patients. The aim of the present study was to assess the influence of extubation failure and prolonged MV on the following variables: postoperative pulmonary complications (PPC), mortality, reoperation, tracheostomy, and duration of postoperative hospitalization following elective intra-cranial surgery. The study involved a prospective observational cohort of 317 patients submitted to elective intracranial surgery for tumors, aneurysms and arteriovenous malformation. Preoperative assessment was performed and patients were followed up for the determination of extubation failure and prolonged MV (>48 h) until discharge from the hospital or death. The occurrence of PPC, incidence of death, the need for reoperation and tracheostomy, and the length of hospitalization were assessed during the postoperative period. Twenty-six patients (8.2%) experienced extubation failure and 30 (9.5%) needed prolonged MV after surgery. Multivariate analysis showed that extubation failure was significant for the occurrence of death (OR = 8.05 [1.88; 34.36]), PPC (OR = 11.18 [2.27; 55.02]) and tracheostomy (OR = 7.8 [1.12; 55.07]). Prolonged MV was significant only for the occurrence of PPC (OR = 4.87 [1.3; 18.18]). Elective intracranial surgery patients who experienced extubation failure or required prolonged MV had a higher incidence of PPC, reoperation and tracheostomy and required a longer period of time in the ICU. Level of consciousness and extubation failure were associated with death and PPC. Patients who required prolonged MV had a higher incidence of extubation failure.en
dc.description.affiliationUniversidade Federal de São Paulo (UNIFESP) Departamento de Fisioterapia
dc.description.affiliationSanta Casa de Misericórdia de Vitória Escola Superior de Ciências Departamento de Fisioterapia
dc.description.affiliationUniversidade Federal de São Paulo (UNIFESP) Departamento de Medicina
dc.description.affiliationUniversidade Federal de São Paulo (UNIFESP) Departamento de Neurocirurgia
dc.description.affiliationUnifespUNIFESP, Depto. de Fisioterapia
dc.description.affiliationUnifespUNIFESP, Depto. de Medicina
dc.description.affiliationUnifespUNIFESP, Depto. de Neurocirurgia
dc.description.sourceSciELO
dc.format.extent1291-1298
dc.identifierhttp://dx.doi.org/10.1590/S0100-879X2011007500146
dc.identifier.citationBrazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 44, n. 12, p. 1291-1298, 2011.
dc.identifier.doi10.1590/S0100-879X2011007500146
dc.identifier.fileS0100-879X2011001200014.pdf
dc.identifier.issn0100-879X
dc.identifier.scieloS0100-879X2011001200014
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/6789
dc.identifier.wosWOS:000297766300014
dc.language.isoeng
dc.publisherAssociação Brasileira de Divulgação Científica
dc.relation.ispartofBrazilian Journal of Medical and Biological Research
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectNeurosurgeryen
dc.subjectCraniotomyen
dc.subjectVentilator weaningen
dc.subjectIntratracheal intubationen
dc.subjectPostoperative perioden
dc.titleImplications of extubation failure and prolonged mechanical ventilation in the postoperative period following elective intracranial surgeryen
dc.typeinfo:eu-repo/semantics/article
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