Cardiothoracic & vascular anaesthesia
Sedation-Ventilation Dyssynchrony Early After Cardiac Surgery Is Associated With Reintubation and Postoperative Complications: A Retrospective Cohort Study With Mediation Analysis
Authors' conclusion
Early ICU SVD was independently associated with a 3-fold higher adjusted risk of reintubation and with consistent increases across organ-specific complications after cardiac surgery.
Study context
- Population
- Consecutive adults admitted intubated to a tertiary cardiac surgical intensive care unit (ICU) after cardiac surgery, January 2021 to December 2025consecutive
- Participants
- 3,124 adults
- Exposure
- Early ICU sedation-ventilation dyssynchrony vs no sedation-ventilation dyssynchrony (SVD)
- SVDn = 780
- Outcome
- Reintubation
- Follow-up
- Within 72 hours of planned extubation
Methodological detailssingle-centre, inverse probability of treatment weighting, Fine-Gray competing-risk regression, multiple imputation, exploratory counterfactual mediation analysis
- Single-centre
- Inverse probability of treatment weighting
- Fine-Gray competing-risk regression
- Multiple imputation
- Exploratory counterfactual mediation analysis
Main finding
As reported in the abstract
SVD vs No SVDEstimate (95% CI)
IPTW-adjusted
aOR 3.4(2.5–4.6)
Reintubation
Fine-Gray subdistribution HR 3.1(2.3–4.3)
- Reintubation, overall
- 157 of 3,124 (5.0%)
- SVD occurrence
- 780 of 3,124 (25.0%)
- E-value for the primary association
- 6.1
Observational data: associations, not effects.
Further findings
| Outcome | aOR |
|---|---|
| NIV/high-flow nasal cannula rescueIPTW-adjusted | 2.2 |
| DeliriumIPTW-adjusted | 2.6 |
| Postoperative AFIPTW-adjusted | 2.1 |
| AKIIPTW-adjusted | 2.9 |
| RRTIPTW-adjusted | 3.2 |
| 30-day mortality · IPTW-adjusted | 2.4 |
Proportion of SVD-AKI association mediated through reintubation (exploratory mediation analysis)
- Proportion compatible with mediation through reintubation, 95% CI 28%-54%
- 41%
- Exploratory
Original publication
Sedation-Ventilation Dyssynchrony Early After Cardiac Surgery Is Associated With Reintubation and Postoperative Complications: A Retrospective Cohort Study With Mediation Analysis. J Cardiothorac Vasc Anesth. Published 25 August 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →