Risk Factors for Prolonged Mechanical Ventilation after Cardiopulmonary Bypass for Open-Heart Surgery in Adults

Cardiopulmonary bypass (CPB) during open-heart surgery is associated with pulmonary complications, such as atelectasis, acute respiratory distress syndrome (ARDS), pulmonary vascular injury and respiratory failure. Many patients require prolonged mechanical ventilation (PMV) as a result. PMV is associated with longer time in hospital, slowed recovery and increased mortality and morbidity. Therefore, it is beneficial for the patient and the hospital that pre-operative, intra-operative, and post-operative risk factors for PMV after CPB are identified and reduced. In this review we have identified risk factors for PMV after CPB for open-heart surgery in adults in order to provide a summary of these risk factors, and potential means by which these risk factors may be reduced. We conclude that there is a need for more studies in this area utilising larger sample sizes and meta-analyses, in order to adequately identify the factors that are consistently associated with PMV risk. This may allow development of a scoring system for PMV risk, so that high-risk patients could be identified prior to cardiac surgery.