Factors Associated with Respiratory Support after Cesarean Hysterectomy
Sirinporn Techapiyaporn MD¹, Maliwan Oofuvong MD, PhD¹ , ²
Affiliation : ¹ Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand ² Medical Sciences Program, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
Background: Cesarean hysterectomy is a major operation that causes massive hemorrhage and larger fluid resuscitation. Thus, postoperative
mechanical ventilation support is required in some patients, involving longer hospital stay and high cost of hospital care.
Objective: To find the predictive factors for postoperative respiratory support in pregnant women underwent cesarean hysterectomy.
Materials and Methods: A retrospective review of patients underwent cesarean hysterectomy between January 2014 and June 2019 was conducted. Patient characteristics, anesthetic records and hospital length of stay were reviewed. The relationship between factors and postoperative mechanical ventilator (PMV) was also analyzed.
Results: A total of 180 patients were included in the present study, wherein, 64 patients (35%) required PMV and 30 patients (16%) needed postoperative oxygen support. Multivariable logistic regression was used to identify the relationship between PMV and the associated factors. The authors found the American Society of Anesthesiologists (ASA) classification and the volume of intraoperative blood components replacement (packed red blood cells [PRC] and fresh frozen plasma [FFP]) were significantly related to PMV: ASA3 16.51 (95% CI 1.89 to 144.33), ASA4 183.25 (95% CI 2.92 to 11,500.65), p=0.003; PRC 1.0028 (95% CI 1.0008 to 1.0047), p=0.001; FFP 1.0022 (95% CI 1.0000 to 1.0043), p=0.029, respectively.
Conclusion: Postoperative mechanical ventilation was found in one-third of the cesarean hysterectomy patients and associated with ICU admission along with increased in post-operative length of hospital stay. The ASA classification and intraoperative volume of blood components replacement were significantly associated with PMV. Factors associated significantly with respiratory support were ASA classification and duration surgery.
Received 23 March 2021 | Revised 5 July 2021 | Accepted 9 July 2021
doi.org/10.35755/jmedassocthai.2021.08.12679
Keywords : Factors associated; Respiratory support; Cesarean hysterectomy
