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  2. Artificial Respiration
IJCS
Original Article

Protocol For Weaning From Mechanical Ventilation in Patients Undergoing Coronary Artery Bypass Grafting: Cohort Study

André Luiz Lisboa Cordeiro et al. Wallace Fernando de Souza Lopes Tainara Conceição de Jesus Ana Julia Gomes de Oliveira … Ana Cecília de Oliveira Coutinho André Raimundo França Guimarães

Abstract

Background:

Patients with heart disease often require mechanical ventilation (MV). Although weaning protocols may reduce the duration of MV, the literature presents contradictory findings regarding their effectiveness, and there is a lack of studies specifically involving cardiac patients.

Objective:

To evaluate whether a weaning protocol reduces the duration of MV compared with weaning based on clinical judgment in cardiac patients.

Methods:

A retrospective cohort study was conducted with patients undergoing myocardial revascularization. They were randomly assigned to either the protocol-driven (intervention) group or the conventional weaning group. Weaning time, MV duration, and length of stay in the Intensive Care Unit (ICU) were assessed. Comparisons between groups were performed using the unpaired Student’s t-test. A p-value <0.05 was considered statistically significant.

Results:

A total of 214 patients were evaluated. The mean duration of MV was shorter in the intervention group (4 vs. 9 hours, p < 0.001). The mean ICU length of stay was 2 vs. 5 days in the intervention and control groups, respectively (p = 0.02).

Conclusion:

The findings suggest that protocol-guided weaning may be associated with reductions in weaning time, duration of MV, and ICU length of stay, raising the hypothesis of a potential clinical benefit that warrants further investigation in future studies.

  • Artificial Respiration
  • Clinical Protocols
  • Intensive Care Units
Ler artigo completo
Creative Commons Attribution (CC BY) Creative Commons license
07/09/2026 DOI: 10.36660/ijcs.20240209 Visualizações 11
IJCS
Editorial

Mechanical Ventilation: Friend or Foe in Cardiac Surgery?

Felipe Saddy

In this number of the journal, the study “Mechanical ventilation time and mortality after coronary artery bypass grafting: A cohort study” evaluated retrospectively 110 patients of a single center, who had no previous lung or kidney disease, submitted to elective open bypass surgery between January 2018 and February 2020. Their aim was to evaluate the impact of mechanical ventilation (MV) on mortality using multivariate analysis of MV time, age, sex and cardiopulmonary bypass (CPB) time. The patients were divided into two groups: patients who needed more than eight hours on MV and those who needed less than eight hours on MV. There was no difference in weaning protocol or in demographic data except for CPB bypass time: 90 ± 12 minutes in the first group (less than eight hours on MV) and 112 ± 16 minutes in the second group (more than eight hours on MV) (p = 0.03). In the univariate analysis, MV time was associated with mortality (HR 0.7 (0.3-0.9), p = 0.01). The authors concluded that MV time longer than eight hours was a predictor of mortality after cardiac surgery.

I wish things could be simple in intensive care, however it is not. Let’s have a deeper approach and make a fair judgement if MV is the real foe. Let’s begin from the beginning: MV is a key part of advanced life support that may directly interfere with patient’s prognosis, for good and for bad. This is not only because of the duration of MV, but also why and how it is used. First, we must evaluate patient’s characteristics: gender, age, body mass index, frailty, EuroSCORE, transfusion, immunosuppression, previous lung disease (which was excluded in the present study), extravascular lung water (to determine lung edema) and both local (bronchoalveolar lavage) and systemic mediators of inflammatory response. Genetics also play an important role and it is worthwhile to mention that CPB, MV (alveolar pressure and/or mechanical distension), transfusion, sepsis, shock and trauma may increase the risk for lung injury.

[…]

  • Acute Lung Injury
  • Artificial Respiration
  • Cardiac Surgical Procedures
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Creative Commons Attribution (CC BY) Creative Commons license
02/06/2025 DOI: 10.36660/ijcs.20250048 Visualizações 4
IJCS
Original Article

Mechanical Ventilation Time and Mortality After Coronary Artery Bypass Grafting: A Cohort Study

Tainá Lís de Araujo Dezidério et al. Vanessa Oliveira da Silva Vitória Novaes Macedo André Luiz Lisboa Cordeiro

Abstract

Introduction:

Cardiac surgery is a procedure that requires great assistance and care. In this way, patients are sent to the intensive care unit (ICU), where they are connected to mechanical ventilation (MV). Prolonged treatment of these patients worsens clinical outcomes and leads to mortality.

Objective:

To evaluate the impact of MV time on patients undergoing cardiac surgery.

Methods:

This is a retrospective cohort study. After surgery, patients were admitted to the ICU and connected to MV. The entire ventilation adjustment and weaning process was conducted according to the unit’s routine. They were divided into two groups, patients who continued on MV for more than eight hours and those who remained for less than eight hours. From this, univariate and multivariate analyses were carried out between predictor variables — MV time, age, sex, and cardiopulmonary bypass (CPB) time — and mortality. We considered p<0.05 as significant.

Results:

A total of 110 patients were evaluated, 25 stayed on MV for more than eight hours. In the univariate analysis, MV time was associated with mortality (HR 0.7 [0.3–0.9], p = 0.01), remaining in the multivariate analysis (HR 0.4 [0.2–0.6), p = 0.01). The other variables were not associated with death outcome.

Conclusion:

MV time of more than eight hours is a predictor of mortality after cardiac surgery, given the contribution of some risk factors.

  • Artificial Respiration
  • Mortality
  • Thoracic Surgery
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Creative Commons Attribution (CC BY) Creative Commons license
12/05/2025 DOI: 10.36660/ijcs.20240236 Visualizações 6

Como citar este artigo

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

Cordeiro ALL, Lopes WFS, Jesus TC, Oliveira AJG, Coutinho ACO, Guimarães ARF. Protocol For Weaning From Mechanical Ventilation in Patients Undergoing Coronary Artery Bypass Grafting: Cohort Study. International Journal of Cardiovascular Sciences 2026;39:e20240209.

Formato de Documento Eletrônico (ABNT)

Cordeiro, André Luiz Lisboa; Lopes, Wallace Fernando de Souza; Jesus, Tainara Conceição de; Oliveira, Ana Julia Gomes de; Coutinho, Ana Cecília de Oliveira; Guimarães, André Raimundo França. Protocol For Weaning From Mechanical Ventilation in Patients Undergoing Coronary Artery Bypass Grafting: Cohort Study. International Journal of Cardiovascular Sciences, v. 39, e20240209, set. 2026.

Formato de Documento Eletrônico (APA)

Cordeiro, A. L. L., Lopes, W. F. S., Jesus, T. C. , Oliveira, A. J. G. , Coutinho, A. C. O., & Guimarães, A. R. F. (2026). Protocol For Weaning From Mechanical Ventilation in Patients Undergoing Coronary Artery Bypass Grafting: Cohort Study. International Journal of Cardiovascular Sciences, 39, e20240209.

Formato de Documento Eletrônico (ISO)

Cordeiro, André Luiz Lisboa and Lopes, Wallace Fernando de Souza and Jesus, Tainara Conceição de and Oliveira, Ana Julia Gomes de and Coutinho, Ana Cecília de Oliveira and Guimarães, André Raimundo França. Protocol For Weaning From Mechanical Ventilation in Patients Undergoing Coronary Artery Bypass Grafting: Cohort Study. International Journal of Cardiovascular Sciences [online]. 2026, vol. 39, [citado 2026-11-15], e20240209. Disponível em: <https://journals.cardiol.br/article/protocol-for-weaning-from-mechanical-ventilation-in-patients-undergoing-coronary-artery-bypass-grafting-cohort-study-2/>. ISSN 2359-4802

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

Saddy F. Mechanical Ventilation: Friend or Foe in Cardiac Surgery?. International Journal of Cardiovascular Sciences 2025;38:e20250048.

Formato de Documento Eletrônico (ABNT)

Saddy, Felipe. Mechanical Ventilation: Friend or Foe in Cardiac Surgery?. International Journal of Cardiovascular Sciences, v. 38, e20250048, jun. 2025.

Formato de Documento Eletrônico (APA)

Saddy, F. (2025). Mechanical Ventilation: Friend or Foe in Cardiac Surgery?. International Journal of Cardiovascular Sciences, 38, e20250048.

Formato de Documento Eletrônico (ISO)

Saddy, Felipe. Mechanical Ventilation: Friend or Foe in Cardiac Surgery?. International Journal of Cardiovascular Sciences [online]. 2025, vol. 38, [citado 2026-11-15], e20250048. Disponível em: <https://journals.cardiol.br/article/mechanical-ventilation-friend-or-foe-in-cardiac-surgery-2/>. ISSN 2359-4802

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

Dezidério TLA, Silva VO, Macedo VN, Cordeiro ALL. Mechanical Ventilation Time and Mortality After Coronary Artery Bypass Grafting: A Cohort Study. International Journal of Cardiovascular Sciences 2025;38:e20240236.

Formato de Documento Eletrônico (ABNT)

Dezidério, Tainá Lís de Araujo; Silva, Vanessa Oliveira da; Macedo, Vitória Novaes; Cordeiro, André Luiz Lisboa. Mechanical Ventilation Time and Mortality After Coronary Artery Bypass Grafting: A Cohort Study. International Journal of Cardiovascular Sciences, v. 38, e20240236, maio. 2025.

Formato de Documento Eletrônico (APA)

Dezidério, T. L. A., Silva, V. O. , Macedo, V. N., & Cordeiro, A. L. L. (2025). Mechanical Ventilation Time and Mortality After Coronary Artery Bypass Grafting: A Cohort Study. International Journal of Cardiovascular Sciences, 38, e20240236.

Formato de Documento Eletrônico (ISO)

Dezidério, Tainá Lís de Araujo and Silva, Vanessa Oliveira da and Macedo, Vitória Novaes and Cordeiro, André Luiz Lisboa. Mechanical Ventilation Time and Mortality After Coronary Artery Bypass Grafting: A Cohort Study. International Journal of Cardiovascular Sciences [online]. 2025, vol. 38, [citado 2026-11-15], e20240236. Disponível em: <https://journals.cardiol.br/article/mechanical-ventilation-time-and-mortality-after-coronary-artery-bypass-grafting-a-cohort-study-2/>. ISSN 2359-4802

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