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\begin{document}

\title{A Comparison between Outcomes of Prolonged Intubation and Reintubation
after Cardiac Surgery}



\author[1]{John Taylor}%
\author[1]{Joanne Thanavaro}%
\author[2]{Linda Vitt}%
\author[2]{Mary Guignon}%
\author[2]{Samer Thanavaro}%
\affil[1]{Saint Louis University}%
\affil[2]{SSM Health}%


\vspace{-1em}



  
  \date{June 15, 2024}


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\begin{abstract}
Background: Early extubation after cardiac surgery results in better
postoperative outcomes but the optimal time for extubation remains
unclear. Premature extubation may lead to unplanned reintubation that
may result in adverse outcomes. The present study was undertaken to
compare preoperative and operative risks and outcomes of patients with
prolonged intubation \textgreater{}48 hours and reintubation after
cardiac surgery. Aims: This is a retrospective chart review of 1259
patients who had cardiac surgery at a community hospital. After
excluding patients with either operating room death, extubation
\textless{}48 hours without reintubation or extubation \textgreater{}48
hours with reintubation, the final sample included 83 patients (6.6\%)
requiring reintubation after extubation in \textless{}48 hours and 100
(8.0\%) with prolonged intubation without requiring reintubation.
Results: Bivariate analyses revealed few statistically different
preoperative and operative risks between patients with reintubation and
prolonged intubation. Reintubation patients were older (p = .033) and
had lower body mass index (p = .000), higher preoperative hematocrit (p
= .021), and more chronic kidney disease stages \textgreater{}2 (p =
.046) but lower odds for intra-aortic balloon pump (p = .006) and
emergency surgery (p = .005). Reintubation led to worse postoperative
outcomes than prolonged intubation: more acute kidney injury stage 1-3
(p = .014), coma/encephalopathy (p = .004), postoperative transfusion (p
= .003), increased intensive care unit length of stay (p = .001) and
hospital mortality (p = .007). Based on binary and ordinal logistic
regression analyses, the differences in preoperative and operative risks
were either inconsistent or trivial contributors and reintubation
appears to make the largest independent contribution to poor
postoperative outcomes. Conclusion: While early extubation remains the
goal, patients with marginal weaning readiness may benefit from more
recovery time before extubation. This study suggests that premature
extubation may increase unplanned reintubation that could adversely
affect postoperative outcomes after cardiac surgery.%
\end{abstract}%



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\verb`Table 5 Prolonged Intubation VS Reintubation.docx`  available at \url{https://authorea.com/users/310869/articles/441975-a-comparison-between-outcomes-of-prolonged-intubation-and-reintubation-after-cardiac-surgery}

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