The impact of the duration of mechanical ventilation on the respiratory outcome in smokers undergoing cardiac surgery

Cardiovasc Surg. 2002 Aug;10(4):345-50. doi: 10.1016/s0967-2109(02)00020-0.


Study objective: To determine the impact of the duration of mechanical ventilation on the rate of pulmonary complications in smokers undergoing cardiac surgery.

Methods: Retrospective analysis of 2163 patients who underwent elective cardiac surgery between September 1993 and August 1999. Based on a 3-month preoperative smoking cessation, patients were classified as smokers, ex-smokers and non-smokers. Their postoperative pulmonary complications were compared and related to the duration of mechanical ventilation.

Results: Postoperative pulmonary complications were twice as common in smokers (29.5%) as non-smokers (13.6%) and ex-smokers (14.7%). Although smokers required a longer duration of mechanical ventilation, this was not statistically significant. Smokers had a higher rate of increase in postoperative pulmonary complications beyond 6 h of mechanical ventilation (P<0.002).

Conclusion: Prolonged mechanical ventilation in active smokers undergoing cardiac surgery is associated with a significant increase in the respiratory morbidity. Surgical strategies that allow early extubation may improve the respiratory outcome in smokers.

MeSH terms

  • Aged
  • Cardiac Surgical Procedures*
  • Coronary Artery Bypass
  • Female
  • Heart Valves / surgery
  • Humans
  • Male
  • Middle Aged
  • Postoperative Care / adverse effects
  • Postoperative Complications*
  • Respiration Disorders / etiology*
  • Respiration, Artificial / adverse effects*
  • Retrospective Studies
  • Risk Factors
  • Smoking / adverse effects*
  • Smoking Cessation
  • Time Factors