ORIGINAL ARTICLE – Endotracheal reintubatioin in post-operative cardiac surgical patients

Abstract

Background: The reported incidence of reintubation in patients who were weaned from mechanical ventilation after cardiac surgery is 6.6%⁴ in a retrospective study, but little work has been done prospectively to find out the incidence and causes for reintubation in a cardiac surgical ICU. We conducted this study to find out incidence and the causes of endotracheal reintubation in patients who were electively ventilated after open heart surgery and were extubated after fulfilling preset criteria for extubation.

Methodology: A total of 1229 consecutive patients were included in the study. On arrival to ICU after cardiac surgery, all patients were electively ventilated with standardized ventilatory parameters. Routine monitoring of all patients was done and patients were extubated once they met the criteria for extubation. The patients, who met the reintubation criteria, were reintubated and the reason(s) noted. Once they stabilized and fulfilled the extubation criteria, they were extubated.

Results: A total of 47(3.82%) patients required reintubation after weaning from the ventilation during the study period, and in 5(10.63%) patients out of these, reintubation was needed more than once. We found a higher incidence of reintubation, 11.84 % and 10.63%, in patients after single and double valve replacement surgery respectively. The incidence was much lower (2.14%) among coronary artery bypass grafting (CABG) patients.

Conclusion: The patients undergoing valve replacement surgery are more prone to reintubation in postoperative period as compared to CABG patients. Impending respiratory failure, cardiovascular (hemodynamic) instability and impaired conscious level are the common indications for reintubation.

Citation: Zahoor A, Azlina N. Endotracheal reintubation in post-operative cardiac surgical patients. Anaesth Pain & Intensive Care 2011;15(1):25-29.