Early extubation after cardiac operations in neonates and young infants.
OBJECTIVE
This study was undertaken to determine the feasibility of early extubation of the neonate and young infant after surgical repair of congenital heart lesions.


METHODS
The records of all patients less than 90 days of age who had cardiac operations over a 1-year period were reviewed. During this time, all patients were managed as potential candidates for early extubation. Fifty-six patients are included with a mean age of 32 +/- 31 days and a mean weight of 3.7 +/- 0.9 kg.


RESULTS
Twenty-eight patients (50%) were extubated in the operating room or within 3 hours after arriving in the intensive care unit. This included 38% of patients less than 7 days of age, 50% of patients 8 to 30 days of age, 44% of patients 31 to 60 days of age, and 69% of patients 61 to 90 days of age. Three patients (11%) extubated early required reintubation. No deaths were related to early extubation. Only one patient was negatively affected by early extubation. Patients extubated early had shorter stays in the intensive care unit (3.3 +/- 3.9 vs 6.7 +/- 2.9 days) and shorter postoperative hospital stays (5.9 +/- 3.3 vs 13.5 +/- 9.7 days), as well as lower intensive care unit ($5,851 +/- $7,225 vs $12,064 +/- $4,419) and total hospital ($21,108 +/- $14,941 vs $31,608 +/- $9,861) costs than patients who were ventilated.


CONCLUSIONS
Early extubation can be accomplished safely in many neonates and young infants undergoing cardiac operations for repair of congenital heart defects and can shorten hospital stay and reduce costs.
Heinle
J S
JS
Cook Children's Medical Center, Fort Worth, Tex 76104, USA.
Diaz
L K
LK
Fox
L S
LS
D002315:Cardiopulmonary Bypass; D005240:Feasibility Studies; D006330:Heart Defects, Congenital / Q000191:economics / Q000601:surgery*; D017721:Hospital Costs; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units / Q000191:economics; D007363:Intensive Care Units, Neonatal / Q000191:economics; D007442:Intubation, Intratracheal; D007902:Length of Stay / Q000706:statistics & numerical data; D011182:Postoperative Care; D011184:Postoperative Period; D012121:Respiration, Artificial; D013997:Time Factors