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Table 1 Demography, clinical presentation, perioperative care, and outcomes of patients with iatrogenic tracheal rupture

From: Thoracotomy for emergency repair of iatrogenic tracheal rupture: single center analysis of perioperative management and outcomes

 

Total (n = 35)

No and minor complications (n = 25)

Major complications (n = 10)

P

Age, years

67 (55–76)

61 (53–73)

75 (58–82)

0.125

Female

25 (71)

18 (72)

7 (70)

0.100

BMI Clinical presentation

26 (24–31)

27 (27–32)

24 (21–29)

0.213

 ASA

4 (3–4)

4.0 (3–4)

4.0 (3.75–5)

0.313

 ICU before rupture

19 (54.3)

14 (56)

5 (50)

0.100

 CPR before rupture

7 (20)

5 (20)

2 (20)

0.100

 SAPS II

52 (36–58)

49 (33–58)

56 (49–67)

0.339

 SOFA

7 (4–9)

7 (4–9)

6 (5–9)

0.567

 Tear length, cm

5 (4–6)

5 (4–6)

4 (4–6)

0.737

Causative events

   

0.438

 Tracheal intubation

20 (57)

15 (60)

5 (50)

 

 Emergency intubation

18 (51)

13 (52)

5 (50)

 

 Tracheotomy

9 (26)

7 (28)

2 (20)

 

 Surgery

6 (17)

3 (12)

3 (30)

 

Interfacility EMS referral

17 (49)

11 (44)

6 (60)

0.392

Process times

 Rupture to surgery, days

0.3 (0.2–1.0)

0.3 (0.2–0.8)

0.7 (0.2–3.4)

0.272

 Anesthesia, minutes

172 (128–261)

160 (125–209)

243 (149–304)

0.093

 Surgery, minutes

100 (68–162)

97 (64–121)

141 (78–222)

0.265

 OLV, minutes

52 (40–99)

55 (40–91)

63 (46–109)

0.401

Anesthesia management

 TIVA

16 (45.7)

12 (48)

4 (40)

0.723

 Tube advancement

27 (77)

18 (72)

9 (90)

0.390

 DLT

11 (31)

4 (4.9)

0 (0.0)

0.120

 Bronchus blocker

3 (9)

1 (4)

2 (20)

0.190

 Devices during surgery

1 (0–2)

1 (0–2)

2 (0–2)

0.388

Tracheotomy

 Before surgery

7 (20)

4 (16)

3 (30)

0.761

 During surgery

6 (17)

5 (20)

1 (10)

 

 After surgery

7 (20)

5 (20)

2 (20)

 

 Not performed

15 (43)

11 (44)

4 (40)

 

Respiratory variables

 FiO2 1.0, %

90 (75–100)

90 (55–100)

95 (80–100)

0.547

 FiO2 other

0.62 (0.5–0.8)

0.6 (0.5–0.75)

0.65 (0.45–0.8)

0.961

 p/f ratio before

141 (110–219)

133 (115–212)

157 (101–315)

0.860

 p/f after

143 (111–153)

144 (133–154)

97 (80–236)

0.042

 SaO2 lowest, %

76 (54–85)

84 (65–88)

54 (24–72)

0.002

 etCO2 highest, mmHg

46 (41–59)

45 (40–59)

51 (42–60)

0.410

 PIP highest, mmHg

25 (25–28)

25 (25–29)

25 (25–28)

0.621

 PEEP highest, mmHg

10 (8–12)

10 (8–11)

10 (8–12)

0.509

Circulation

 SBP lowest, mmHg

74 (52–82)

80 (70–86)

40 (0–72)

< 0.001

 Noradrenaline, μg kg min−1

0.18 (0.1–0.31)

0.10 (0.06–0.22)

0.22 (0.2–0.84)

a

 Adrenaline

8 (22.9)

1 (4)

7 (70)

a

 Dobutamine

9 (25.7)

5 (20)

4 (40)

0.398

 Crystalloid, L

2 (1–2.5)

1.5 (1–2)

2.5 (1–4)

0.009

 Transfusion

14 (40)

8 (32)

6 (60)

0.151

 Blood loss, ml

450 (250–750)

350 (250–575)

725 (312–1150)

0.107

 Lactate before, mmol/l

1.3 (0.8–2.6)

1.4 (1–2.6)

1.1 (0.7–2.4)

0.604

 Lactate after, mmol/l

1.4 (1.1–3.1)

1.3 (0.9–2.9)

2.8 (1.5–5.6)

0.083

 Urinary output, ml

50 (0–100)

50 (0–100)

25 (0–162)

0.734

Outcome

 Ventilator days

9 (4–18)

10 (4–25)

8 (3–14)

0.494

 LOS ICU, days

10 (6–24)

11 (6–33)

9 (5–14)

0.118

 All-cause 30-day mortality

16 (46)

7 (28)

9 (90)

0.002

 Adjusted mortality

7 (20)

1 (4)

6 (60)

0.001

  1. Data are medians (IQR) and counts (%); a, comparisons not applicable due to categorization; BMI body mass index, ASA American Society of Anesthesiologists classification, ICU intensive care unit, CPR cardiopulmonary resuscitation, SAPS II simplified acute physiology score revision two, SOFA sequential organ failure assessment, EMS emergency medical service, OLV one-lung ventilation, DLT double lumen tube, p/f paO2/FiO2-ratio, PIP peak inspiratory pressure, PEEP positive end-expiratory pressure, LOS length of stay. P values below 0.05 are significant