Objectives: This study evaluated the morbid results of
prolonged intubation after coronary artery bypass grafting (CABG).
Methods: Over 30 months, 66 of 1,112 patients undergoing
CABG required prolonged intubation. They were matched with 66 patients
who did not require prolonged intubation. Preoperative and operative
variables were evaluated to determine which would predict prolonged
intubation. The postoperative courses were then compared to evaluate
the effect of prolonged intubation. The study population was divided
into three groups: those who underwent early extubation, but required
reintubation (n = 24); those who required initial prolonged
intubation, but no reintubation (n = 22); and those who required
initial prolonged intubation and reintubation (n = 20).
Results: Univariate analysis revealed unstable angina
(p = 0.037), elevated creatinine (p = 0.001), reduced
FEV1 (p = 0.019), longer cardiopulmonary bypass time
(p = 0.009), and a greater positive fluid balance at 24 h
(p = 0.0001) as predictors of postoperative prolonged intubation.
Multivariate regression analysis revealed elevated creatinine
(p = 0.011), FEV1 (p = 0.022), and fluid balance
(p = 0.001) as predictors of prolonged intubation. The study
population had longer ICU and hospital stays (p = 0.0001), with more
infectious complications (p = 0.0001) and higher mortality
(p = 0.001). In the subgroups of the study population, patients not
requiring reintubation had shorter ICU (p = 0.001) and hospital stays
(p = 0.0001), fewer infectious complications (p = 0.0001), and
reduced mortality (p = 0.0001).
Patients undergoing CABG with reduced FEV1, renal failure,
and positive fluid balance 24 h postoperatively are at risk for
prolonged intubation. Prolonged intubation results in significant acute
and midterm morbidity and mortality. Early extubation followed by
reintubation further increases morbidity and mortality rates in these