Key result
Early peak lactate is linked to ~35% higher risk of prolonged mechanical ventilation after CABG.
Why the study?
Patients requiring prolonged mechanical ventilation after coronary artery bypass graft surgery have increased morbidity and mortality, but new risk factors for PMV remain to be identified.
Observational (n=339)
No
Odds Ratio: 1.35 (95% CI 1.2–1.53)
p-value: p=<0.001
Longer cardiopulmonary bypass time, early postoperative lactate peaks, and higher preoperative EuroSCOREs can help identify post-CABG patients at risk for prolonged mechanical ventilation, allowing for targeted intensive care management.
May aid risk stratification for prolonged ventilation after CABG; extends observational predictors but leaves causal modification open.
Background: Postoperative intensive care plays a crucial role in the perioperative management of coronary artery bypass graft (CABG) surgery. It is well established that patients requiring prolonged mechanical ventilation (PMV) have an increased risk of developing multiple secondary complications such as ventilator-associated pneumonia accounting for the increase of overall morbidity and mortality. The primary focus of our investigation was to identify new risk factors associated with PMV following CABG surgery. Methods: All patients who underwent isolated coronary artery bypass surgery and were treated in an interdisciplinary surgical intensive care unit (ISICU) of a tertiary University Medical Center in 2023 were included in this retrospective observational study. Results: 0.0%, P<0.001). Multivariate logistic regression analysis revealed longer time on CPB [odds ratio (OR) =1.01, 95% confidence interval (CI): 1-1.02], a lactate peak within the first 24 hours (OR =1.35, 95% CI: 1.2-1.53), and a higher preoperative EuroSCORE (OR =1.23, 95% CI: 1.05-1.45) as significant independent association for the development of PMV. Conclusions: Comprehensive understanding of the factors that increase the risk of PMV and a precise characterization of patients prone to PMV are considered essential for the management by the attending intensivist. Early identification of risk factors enables the implementation of targeted interventions, which may optimize intensive care management and ultimately contribute to improved patient outcomes.
No takes yet. Share an insight, caveat, or question.
Möller et al. (2025) conducted an observational in Isolated coronary artery bypass grafting (CABG) (n=339). Elevated peak lactate within 24 hours vs. Lower peak lactate was evaluated on Prolonged mechanical ventilation (PMV) > 24 hours (OR 1.35, 95% CI 1.2-1.53, p=<0.001). An elevated lactate peak within the first 24 hours (OR 1.35), prolonged cardiopulmonary bypass time, and a higher preoperative EuroSCORE independently predicted prolonged mechanical ventilation following CABG.