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Intensive Care Medicine

, Volume 31, Issue 3, pp 491–492 | Cite as

Coronary artery bypass graft surgery for persistent weaning failure

  • Apostolos Koroneos
  • Panagiotis Dedeilias
  • Christina Routsi
  • Anastasia Kotanidou
  • Ilias Andrianakis
  • Ioannis Floros
  • Marinos Pitaridis
  • Charis Roussos
Correspondence
  • 38 Downloads

Sir: Failure to wean from mechanical ventilation (MV) results in prolonged and expensive ICU stay with a high mortality rate [1]. A cornerstone in the therapy is identification and subsequent treatment of the underlying reason for failure. Although myocardial ischemia is a potential reason, it is not easy documented, and effective treatment is not always feasible in critically ill patients [2].

A 76-year-old man with chronic obstructive pulmonary disease was admitted to the hospital with worsening dyspnea and fever of 38°. Chest radiography showed bilateral pulmonary infiltrates in the lower lobes, predominantly of the right lung. Laboratory findings and 12-lead electrocardiography were normal. Echocardiography showed inferior hypokinesia but otherwise normal global systolic function, and a significant valve dysfunction was excluded. Three hours later the patient developed severe respiratory failure (PO 2 43 mmHg, PCO 2 68 mmHg, pH 7.24, HCO 3 28 mmol/l) on a nonrebreather mask. He was...

Keywords

Chronic Obstructive Pulmonary Disease Coronary Artery Bypass Graft Left Anterior Descend Left Internal Mammary Artery Spontaneous Breathing Trial 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Quality of Life After Mechanical Ventilation in the Aged Study Investigators (2002) Two-month mortality and functional status of critically ill adults receiving prolonged mechanical ventilation. Chest 121:549–558CrossRefGoogle Scholar
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    Srivastava S, Chatila W, Amoateng-Adjepong Y, Kanagasegar S, Jacob B, Zarich S, Manthous C (1999) Myocardial ischemia and weaning failure in patients with coronary artery disease: an update. Crit Care Med 27:2109–2112CrossRefGoogle Scholar
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    Lemaire F, Teboul JL, Cinotti L, Giotto G, Abrouk F, Steg C, Macquin-Mavier I, Zapol WM (1988) Acute left ventricular dysfunction during unsuccessful weaning from mechanical ventilation. Anesthesiology 69:171–179Google Scholar
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    Demoule A, Lefort Y, Lopez ME, Lemaire F (2004) Successful weaning from mechanical ventilation after coronary angioplasty. Br J Anaesth 93:295–297CrossRefGoogle Scholar
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    American College of Cardiology/American Heart Association Task Force on Practice Guidelines (2004) Guideline update for coronary artery bypass graft surgery. J Am Coll Cardiol 44:e213–e310CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Apostolos Koroneos
    • 1
  • Panagiotis Dedeilias
    • 2
  • Christina Routsi
    • 1
  • Anastasia Kotanidou
    • 1
  • Ilias Andrianakis
    • 1
  • Ioannis Floros
    • 1
  • Marinos Pitaridis
    • 1
  • Charis Roussos
    • 1
  1. 1.Department of Critical Care and Pulmonary Services, Medical SchoolAthens University, Evangelismos HospitalAthensGreece
  2. 2.Department of Cardiothoracic SurgeryEvangelismos HospitalAthensGreece

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