Cardiothoracic & vascular anesthesia
Persistent diaphragm dysfunction after cardiac surgery is associated with adverse respiratory outcomes: a prospective observational ultrasound study
Authors' conclusion
The incidence of persistent diaphragm dysfunction was 8% in patients undergoing elective cardiac surgery and was associated with adverse respiratory outcomes.
Study context
- Population
- Consecutive adults (>18 yr) undergoing elective cardiac surgeryincluded in the analysis
- Participants
- 122 adults
- Exposure
- Persistent diaphragm dysfunction vs No dysfunction
- Persistent diaphragm dysfunctionn = 10
- No dysfunctionn = 112reference
- Outcome
- Incidence of persistent diaphragm dysfunction (ultrasound excursion below lower limit of normal)
- Follow-up
- After the seventh postoperative day
Methodological detailssingle-centre, observational, ultrasound (M-mode)
- Single-centre
- Observational
- Ultrasound (M-mode)
Main finding
As reported in the abstract
Incidence of persistent diaphragm dysfunction after the seventh postoperative day
Patients with diaphragm dysfunction after the seventh postoperative day
10
8%
Observational data: associations, not effects.
Further findings
| Outcome | Persistent diaphragm dysfunction | No dysfunction | Difference in medians (hr) (95% CI) | P value | |
|---|---|---|---|---|---|
| Duration of NIV | median 8 (IQR 0–34) hr | median 0 (IQR 0–0) hr | 8 (0–22) | P < 0.001 | |
| Duration of invasive mechanical ventilation | median 5 (IQR 3–257) hr | median 3 (IQR 2–4) hr | 2 (0.5–41) | P = 0.008 | |
| −200204060Difference, hr (linear scale) |
| Outcome | Persistent diaphragm dysfunction | No dysfunction | RR (95% CI) | P value | |
|---|---|---|---|---|---|
| Reintubation | 40% | 0.9% | 45 (7.1–278) | P < 0.0001 | |
| Pneumonia | 40% | 6% | 6 (2–16) | P < 0.001 | |
| 0.050.21520Relative risk (log scale) |
Median, days
| Outcome | Persistent diaphragm dysfunction | No dysfunction | Difference in medians (days) (95% CI) | P value | |
|---|---|---|---|---|---|
| ICU LOS | 8 (IQR 5–29) | 4 (IQR 2–6) | 4 (2–12) | P = 0.002 | |
| −5051015Difference, days (linear scale) |
Original publication
Persistent diaphragm dysfunction after cardiac surgery is associated with adverse respiratory outcomes: a prospective observational ultrasound study. Can J Anaesth. Published 13 December 2022. doi:10.
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