Objective: To explore the related factors of delayed extubation of endotracheal intubation after heart valve operation under cardiopulmonary bypass(CPB), and further analyze its independent risk factors. Methods: The clinical data of 220 patients who met the inclusion and exclusion criteria were collected and divided into delayed extubation group(postoperative tube time ≥ 24 h) and non-delayed extubation group(postoperative tube time<24 h). The differences between the two groups were analyzed to determine the relevant influencing factors. Multivariate Logistic regression analysis was employed to determine the independent influencing factors. Results: Among the 220 patients after heart valve operation, delayed extubation occurred in 43 cases(19.55%). 14 cases died in perioperative period, with an incidence of 6.36%. Univariate analysis showed that the following factors were related to the occurrence of delayed extubation after heart valve operation under CPB:(1) gender, age, smoking history, cerebral infarction history, cardiac function NYHA classification, tricuspid regurgitation degree, pulmonary hypertension degree;(2) preoperative platelet count, aspartate aminotransferase, alkaline phosphatase, prealbumin and hemoglobin levels;(3) preoperative thyroid dysfunction, coronary angiography and atrial fibrillation;(4) time of cardiopulmonary bypass and of aortic blockade. Multivariate Logistic regression analysis showed that preoperative low platelet count(OR=0.989, 95%CI 0.982-0.996), preoperative low hemoglobin level(OR=0.970, 95%CI 0.950-0.990), preoperative atrial fibrillation(OR=3.123, 95%CI 1.232-7.913) and prolonged intraoperative cardiopulmonary bypass(OR=1.017, 95%CI 1.003-1.030) were independent risk factors for delayed extubation of heart valves under CPB(P<0.05). The ICU stay time(P<0.001) and postoperative hospitalization time(P=0.035) were prolonged in the delayed extubation group, and the perioperative complications and mortality were higher than those in the non-delayed extubation group. Conclusion: Preoperative low platelet count, preoperative low hemoglobin level, prolonged CPB time and preoperative atrial fibrillation are independent risk factors for delayed extubation of endotracheal intubation after cardiac valve operation. Delayed extubation can increase the incidence of perioperative complications and mortality, and prolong the ICU and postoperative hospital stay. |
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