Amiodarone use and prolonged mechanical ventilation after cardiac surgery: a single-center analysis

Abstract Background Prolonged mechanical ventilation (PMV) after cardiac surgery increases the risk of complications such as pulmonary atelectasis and ventilator-associated pneumonia. This study aims to investigate the risk factors associated with delayed extubation, including the impact of cardiova...

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Main Authors: Xin Li, Haitao Zhang, Yuanxi Luo, Jiqing Zhu, Dongjin Wang, Li Xu
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Cardiovascular Disorders
Subjects:
Online Access:https://doi.org/10.1186/s12872-025-04576-0
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author Xin Li
Haitao Zhang
Yuanxi Luo
Jiqing Zhu
Dongjin Wang
Li Xu
author_facet Xin Li
Haitao Zhang
Yuanxi Luo
Jiqing Zhu
Dongjin Wang
Li Xu
author_sort Xin Li
collection DOAJ
description Abstract Background Prolonged mechanical ventilation (PMV) after cardiac surgery increases the risk of complications such as pulmonary atelectasis and ventilator-associated pneumonia. This study aims to investigate the risk factors associated with delayed extubation, including the impact of cardiovascular medication. Method This retrospective, single-center study analyzed 1,976 patients who underwent open heart surgery at Nanjing Drum Tower Hospital from October 2020 to January 2023. Patients were categorized into early extubation (n = 1071) and delayed extubation (n = 905) groups. Multivariate logistic regression was employed to identify risk factors for delayed extubation. Amiodarone were indicated to be associated with delayed extubation. To further address bias, we derived a propensity score predicting the function of Amiodarone on delayed extubation, and matched 228 cases to 684 controls with similar risk profiles. Results Multivariate analysis confirmed that hypertension, stroke, amiodarone use, age, LVEF, CPB time, and DHCA were significant predictors of delayed extubation. Postoperative use of amiodarone was significantly associated with delayed extubation (OR:1.753, 95%CI: 1.287–2.395, P < 0.001). PSM analysis further confirmed that patients receiving amiodarone had longer ventilation times, prolonged hospital stays, and higher in-hospital mortality. Conclusion Postoperative use of amiodarone is a significant predictor of delayed extubation, warranting careful consideration in clinical practice. Further research is needed to clarify the causal relationship between amiodarone use and extubation outcomes.
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spelling doaj-art-a5fcd270887c49be8aec83e8e02ec4d52025-08-20T02:59:35ZengBMCBMC Cardiovascular Disorders1471-22612025-02-012511810.1186/s12872-025-04576-0Amiodarone use and prolonged mechanical ventilation after cardiac surgery: a single-center analysisXin Li0Haitao Zhang1Yuanxi Luo2Jiqing Zhu3Dongjin Wang4Li Xu5Department of Cardiac Surgery, Nanjing Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Graduate School of Peking Union Medical CollegeDepartment of Cardiac Surgery, Nanjing Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Graduate School of Peking Union Medical CollegeDepartment of Cardiac Surgery, Nanjing Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Graduate School of Peking Union Medical CollegeDepartment of Anesthesia, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Cardiac Surgery, Nanjing Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Graduate School of Peking Union Medical CollegeClinical Trial Institution, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical SchoolAbstract Background Prolonged mechanical ventilation (PMV) after cardiac surgery increases the risk of complications such as pulmonary atelectasis and ventilator-associated pneumonia. This study aims to investigate the risk factors associated with delayed extubation, including the impact of cardiovascular medication. Method This retrospective, single-center study analyzed 1,976 patients who underwent open heart surgery at Nanjing Drum Tower Hospital from October 2020 to January 2023. Patients were categorized into early extubation (n = 1071) and delayed extubation (n = 905) groups. Multivariate logistic regression was employed to identify risk factors for delayed extubation. Amiodarone were indicated to be associated with delayed extubation. To further address bias, we derived a propensity score predicting the function of Amiodarone on delayed extubation, and matched 228 cases to 684 controls with similar risk profiles. Results Multivariate analysis confirmed that hypertension, stroke, amiodarone use, age, LVEF, CPB time, and DHCA were significant predictors of delayed extubation. Postoperative use of amiodarone was significantly associated with delayed extubation (OR:1.753, 95%CI: 1.287–2.395, P < 0.001). PSM analysis further confirmed that patients receiving amiodarone had longer ventilation times, prolonged hospital stays, and higher in-hospital mortality. Conclusion Postoperative use of amiodarone is a significant predictor of delayed extubation, warranting careful consideration in clinical practice. Further research is needed to clarify the causal relationship between amiodarone use and extubation outcomes.https://doi.org/10.1186/s12872-025-04576-0Cardiac surgeryAmiodaroneDelayed extubation
spellingShingle Xin Li
Haitao Zhang
Yuanxi Luo
Jiqing Zhu
Dongjin Wang
Li Xu
Amiodarone use and prolonged mechanical ventilation after cardiac surgery: a single-center analysis
BMC Cardiovascular Disorders
Cardiac surgery
Amiodarone
Delayed extubation
title Amiodarone use and prolonged mechanical ventilation after cardiac surgery: a single-center analysis
title_full Amiodarone use and prolonged mechanical ventilation after cardiac surgery: a single-center analysis
title_fullStr Amiodarone use and prolonged mechanical ventilation after cardiac surgery: a single-center analysis
title_full_unstemmed Amiodarone use and prolonged mechanical ventilation after cardiac surgery: a single-center analysis
title_short Amiodarone use and prolonged mechanical ventilation after cardiac surgery: a single-center analysis
title_sort amiodarone use and prolonged mechanical ventilation after cardiac surgery a single center analysis
topic Cardiac surgery
Amiodarone
Delayed extubation
url https://doi.org/10.1186/s12872-025-04576-0
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