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Seminars in Cardiothoracic and Vascular Anesthesia
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Liberation From Mechanical Ventilation Following Heart Surgery

Edward D. Sivak, MD

State University of New York, Health Science Center, Syracuse, NY

The definition of ventilator dependency following heart surgery has evolved from a requirement for mechanical ventilation for more than 48 hours to less than 24 hours. Minimization of risk factors assessed in the preoperative period and improved surical and anesthetic techniques lead to improved and shortned postoperative courses and decreased hospital lengths of stay. The management of ventilator dependency following heart surgery should be approached from the perspective of pre-intensive care unit, intensive care unit, and post-intensive care unit Issues. A thorough understanding of risk factors for adverse postoperative morbidity and mortality leads to foused intraoperative and postoperative management aimed at improved quality of life following surgery. Minimizing preoprative risks and matching the postoperative state with criteria for the ideal candidate for early extubation improves outcome and minimizes requirements for mechanical ventilation in the postoperative period. In the event of prolonged requirements for mechanical ventilation, correcting impediments to weanng from mechanical ventilation provides the best circumtances to facilitate the process of rehabilitation and liberaion from mechanical ventilation.

Seminars in Cardiothoracic and Vascular Anesthesia, Vol. 6, No. 3, 203-217 (2002)
DOI: 10.1177/108925320200600304
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