Early extubation after coronary artery bypass surgery: effects on oxygen flux and haemodynamic variables.
The effect of extubation within the first postoperative hour was evaluated in 13 patients (mean +/- SD age 59 +/- 6 years) undergoing elective coronary artery bypass surgery without active systemic hypothermia. The mean cardiopulmonary bypass time was 50 +/- 14 minutes. Postoperative improvements in cardiac index and oxygen uptake (from 2.0 +/- 0.4 l/min/m2 and 144 +/- 26 ml/min postinduction to 2.88 +/- 0.76 l/min/m2 and 229 +/- 104 ml/min, p less than 0.01) were maintained following extubation. Lower postoperative systemic and pulmonary vascular resistances (p less than 0.01) did not change to a significant extent following extubation. Despite a two-fold rise in the intrapulmonary shunt (Qs/Qt) following surgery (18.5 +/- 9.7% vs 9.6 +/- 3.2% before surgery) the immediate post-extubation value was similar (18.8 +/- 8.2%) and all patients were discharged from the cardiac recovery area within 16 hours without complication. Extubation within the first postoperative hour is a safe procedure following elective coronary artery surgery with short bypass times where sustained hypothermia less than 32 degrees C is avoided.
Butler
J
J
Department of Cardiothoracic Surgery, John Radcliffe Hospital, Oxford, UK.
Chong
G L
GL
Pillai
R
R
Westaby
S
S
Rocker
G M
GM
D000368:Aged; D000704:Analysis of Variance; D000762:Anesthesia Recovery Period; D001784:Blood Gas Analysis; D001026:Coronary Artery Bypass; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D013997:Time Factors