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Prolong Intubation Post Coronary Artery Bypass Grafts - Article Example

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This essay discusses that critical care units have a good number of patients who are intubated for the prolonged duration of time. The most common causes for intubation are relief of upper airway obstruction, ventilatory assistance and to aid tracheobronchial toileting…
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Prolong Intubation Post Coronary Artery Bypass Grafts
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Download file to see previous pages The most common complication of this surgery is prolonged mechanical ventilation. Prolonged intubation can contribute to significant mortality and morbidity. It is associated with the longer stay in the intensive care unit and also in the hospital, increased rate of infections, increased medical expenses and other complications (Cohen et al, 2000). Other complications include atelectasis, decreased lung volumes and nosocomial pneumonia (Imanipour et al, 2008). Delay in activity regimens can also occur. Prolonged intubation can result in various laryngeal sequelae. Studies have shown that 63 to 94% of intubations result in laryngeal injuries of which 10- 22% are permanent sequelae (Cohen et al, 2000). The sequelae are directly related to the duration of intubation. The laryngeal sequelae include a cough, dysphagia, hoarseness of voice, stridor, and aspiration. The injuries can manifest in the form of erythema, granulomas, ulceration, subglottic stenosis, arytenoid dislocations and vocal fold immobility (Cohen et al, 2000). Laryngeal complications are also related to a larger size of the tube, higher cuff pressures, emergency intubations and skill of the intubating physician (Cohen et al, 2000).
CABG is a costly procedure with a mean cost of about 44000 US$ (Branca, 2001 qt. in Imanipour et al, 2008). 25% of the cost is due to the stay in critical care unit in the postoperative period. The estimated mean duration of stay in the critical care unit ranges from 2.5days to 6 days (Doering, 1998; qt. in Imanipour et al, 2008). The length of stay is obviously directly dependent on the duration of mechanical ventilation.
Previously, cardiac patients were sedated and mechanically ventilated for more than a day after surgery to give time for major organs to recover from drastic physiological changes which are expected to be induced by cardiopulmonary bypass (Rady and Ryan, 1999; qt. in Imanipour et al, 2008).  ...Download file to see next pagesRead More
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