The Influence of the Mechanical Ventilation Weaning Protocol in Patients With Acute Kidney Injury Undergoing Adult Cardiac Surgery

Document Type : Original Article


1 Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

2 Faculty of medicine, Birjand University of Medical Sciences, IR Iran.


Background: Mechanical ventilation is an important risk factor for acute kidney injury (AKI) in cardiac surgery patients. The Weaning protocol can speed weaning after open-heart surgery and might reduce the AKI risk in these patients. We explore the influence of the weaning protocol on the intubation time in cardiac surgery patients who developed AKI.
Methods: In a randomized clinical trial, 100 patients with AKI after open-heart surgery were enrolled. After surgery, the patients were randomized to the weaning protocol group (the intervention group) and the conventional weaning group (the control group). Arterial blood gas, hemodynamic variables, the serum blood urea nitrogen level, the creatinine level, and the intubation time were recorded and compared between the 2 groups.
Results: The weaning protocol group displayed a statistically significant shorter intubation time than the conventional weaning group (8.89±1.74 h vs 9.93±1.56 h; P=0.002). The postoperative serum urea level (r=0.240, P<0.016) and creatinine level (r=0.245, P<0.014) were positively correlated with the intubation time and the weaning protocol compared with conventional weaning. The weaning protocol decreased the urea and creatinine levels in cardiac surgery patients (P<0.04).
Conclusions: The use of the weaning protocol in cardiac surgery patients with AKI conferred shorter intubation times and lower blood urea nitrogen and creatinine levels than the use of conventional weaning. (Iranian Heart Journal 2021; 22(4): 6-14)


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