[Decision on the time for post-operative extubation of maxillofacial surgery patient in the intensive care unit].
OBJECTIVE
Evaluate moment of extubation in maxillofacial post-operative patients admitted to an intensive care unit (ICU) and analyze early complications during their stay.


METHODS
An observational and prospective study.


METHODS
Third level hospital ICU.


METHODS
All patients we underwent maxillofacial surgery and admitted to the ICU for immediate post-operative care from February 2007 to March 2008 were studied. Demographic and clinical data variables of the patients, anesthesic variables prior to surgery and mechanical ventilation and postoperative complications during their stay in the ICU were recorded.


RESULTS
A total of 102 patients were collected during the study. Of these, 58 (55.8%) patients were extubated early (within the first 4 hours of admission). Global rate of complications was 12.5%. Length of mechanical ventilation was longer in patients who required cervical lymph node extraction (p = 0.0031). We found an association between complications and late extubation (p = 0.034; OR = 3.78; 95% CI, 1.16-12.31). The multivariant study showed that late extubation and surgery that required lymph node extraction are predictors of complications.


CONCLUSIONS
In our series, late extubation and the need for cervical lymph node extraction were independent risk factors for complications in ICU. Although early extubation may be hazardous in some cases in the first hours, we have no consistent data to maintain mechanical ventilation longer than needed to recover from the anesthesia.
Curiel Balsera
E
E
Unidad de Cuidados Intensivos, Hospital Regional Universitario Carlos Haya, Málaga, España. emiliouci@ya.com
Prieto Palomino
M A
MA
Muñoz Bono
J
J
Arias Verdú
M D
MD
Mora Ordóñez
J
J
Quesada García
G
G
D003422:Critical Care; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000379:methods; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures; D011182:Postoperative Care; D011446:Prospective Studies; D013997:Time Factors