1. A logistic regression analysis comparing minimalistic approach and intubation anaesthesia in patients undergoing transfemoral transcatheter aortic valve replacement
- Author
-
Benedikt Hammerich, Jochen Reinöhl, Wolfgang Bothe, Klaus Kaier, Frank Humburger, Christoph Bode, Holger Schröfel, Constantin von zur Mühlen, Alexander Maier, Thomas Brieschal, Peter Stachon, Timo Heidt, and Manfred Zehender
- Subjects
Male ,Pacemaker, Artificial ,medicine.medical_treatment ,General Anesthesia ,Conscious Sedation ,030204 cardiovascular system & hematology ,Logistic regression ,law.invention ,0302 clinical medicine ,Postoperative Complications ,Valve replacement ,Aortic valve replacement ,law ,Anesthesiology ,Risk Factors ,Medicine and Health Sciences ,Intubation ,Anesthesia ,030212 general & internal medicine ,Aged, 80 and over ,Multidisciplinary ,Pharmaceutics ,Arteries ,Intensive care unit ,Hospitals ,Femoral Artery ,Intensive Care Units ,Sedation ,Medicine ,Engineering and Technology ,Female ,medicine.symptom ,Pacemakers ,Anatomy ,Research Article ,Biotechnology ,Science ,Surgical and Invasive Medical Procedures ,Bioengineering ,Transcatheter Aortic Valve Replacement ,03 medical and health sciences ,Drug Therapy ,medicine ,Humans ,Mechanical ventilation ,Pharmacology ,business.industry ,Biology and Life Sciences ,Femoral Arteries ,medicine.disease ,Respiration, Artificial ,Health Care ,Logistic Models ,Health Care Facilities ,Cardiovascular Anatomy ,Delirium ,Blood Vessels ,Medical Devices and Equipment ,Local and Regional Anesthesia ,business - Abstract
AIMS:Patients with postoperative delirium (POD) after transcatheter aortic valve replacement (TAVR) are ventilated and hospitalized longer and suffer increased in-hospital mortality. This study hypothesized that a minimalistic approach with conscious sedation during transfemoral aortic valve replacement (TF-AVR) protects against delirium, time of mechanical ventilation, and increased length of stay in intensive care unit (ICU) compared to intubation anaesthesia. METHODS AND RESULTS:308 patients which underwent TF-AVR in our centre between 01/2013 and 08/2017 were retrospectively evaluated regarding postoperative delirium, time of mechanical ventilation, and days in ICU. TF-AVR was performed with intubation anaesthesia in 245 patients and with conscious sedation in 63. The operative risk estimated by the logEUROScore was similar in both groups (intubation: 13.28 +/-9.06%, conscious sedation: 12.24 +/-6.77%, p = 0.395). In the conscious sedation group procedure duration was shorter (0.61 +/-0.91h vs. 1.75 +/-0.96h, p
- Published
- 2020