Optimizing early extubation after coronary surgery.
Early extubation after isolated coronary artery bypass surgery was assessed retrospectively in 545 of 779 patients treated by the same surgical team over one year. All underwent extubation within 10 hr of arrival at the cardiothoracic intensive care unit: 343 in < 6 hr and 202 in 6-10 hr. Operative mortality was 2.2%. Group comparisons revealed that patients who had earlier extubation were younger (61 vs. 66 years; p < 0.001), more likely to be male (72.5% vs. 61.3%; p < 0.05), with a shorter aortic crossclamp time (49.2 +/- 15.0 vs. 53.3 +/- 14.0 min; p < 0.05), cardiopulmonary bypass time (65 +/- 18.4 vs. 72.2 +/- 19.2 min; p < 0.05), intensive care unit stay (18.8 +/- 5.6 vs. 22.4 +/- 3.2 hr; p < 0.05) and postoperative hospital stay (5.2 +/- 2.2 vs. 6.0 +/- 2.4 days; p = 0.01). Extubation < 6 hr after cardiopulmonary bypass may accelerate recovery. The finding of no significant differences in clinical parameters between the groups suggests that efforts to further reduce the time to extubation might be worthwhile.
Georghiou
Georgios P
GP
Department of Cardiothoracic Surgery, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel. georgios@ahi.com.cy
Stamler
Alon
A
Erez
Eldad
E
Raanani
Ehud
E
Vidne
Bernardo A
BA
Kogan
Alexander
A
D000367:Age Factors; D000368:Aged; D001026:Coronary Artery Bypass; D003422:Critical Care / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate; D013997:Time Factors; D015300:Ventilator Weaning / Q000706:statistics & numerical data