Clinical Analysis of Prolonged Mechanical Ventilation >72 h Following Acute Type A Aortic Dissection Repair

Genta Chikazawa, Kentaro Tamur

Abstract

Background: Influencing factors for prolonged mechanical ventilation (PMV) following acute type A aortic dissection repair (AADR) were investigated. Material and methods: 325 patients receiving AAADR were enrolled. They were divided into two groups based on the duration of mechanical ventilation; 72 h or less (Group A; n=250) and more than 72 h (Group B; n=75). Results: Preoperative backgrounds showed % of those with COPD, redo operative cases, mal-perfusion to coronary arteries or lower limbs were significantly higher in Group B. Procedure related data revealed that operation time, cardio-pulmonary bypass time, aortic cross clamp time, and postoperative ICU stay were significantly longer in Group B. There were more intraoperative bleeding amounts identified in Group B. % of those complicated with postoperative acute renal failure were significantly higher in Group B. 30-day mortality was significantly higher in Group B. Multivariate analysis demonstrated that COPD, preoperative mal-perfusion to vital organs or lower limbs, operation time were significantly influencing factors of PMV. Conclusions: COPD, mal-perfusion to vital organs or lower limbs, prolonged operation time were influencing factors for PMV. Identifying them could help to establish optimal perioperative management strategies following AAADR.