Low preoperative cerebral oxygen saturation is associated with longer time to extubation during fast-track cardiac anaesthesia.
OBJECTIVE
Fast-track cardiac anaesthesia programs aiming at early tracheal extubation have not only been linked to a decrease in intensive care unit and hospital length of stay but also to a decrease in morbidity and mortality as well as a containment of rising medical costs. General recommendations for the inclusion criteria concerning fast-track programs are not available.


METHODS
The present study determined the factors influencing the time to extubation in patients undergoing a newly implemented fast-track protocol. Seventy-nine patients were retrospectively studied. Successful fast track was defined as time to extubation within 75 min after admission to ICU.


RESULTS
Sixty patients fulfilled the successful fast-track criteria with a mean time to extubation of 43.9 min (range 15-75 min). Nineteen patients needed more than 75 min to be weaned from the respirator with a mean time to extubation of 135 min (range 90-320 min). Analysis of pre- and intraoperative factors revealed that these groups differed only with respect to preoperative cerebral oxygen saturation levels: 67.7 ± 5.2 versus 60.8 ± 7.4%.


CONCLUSIONS
Cerebral oxygen saturation assessment prior to cardiac surgery is significantly related to time to extubation and may thus be used to stratify candidates in fast-track programs.
Department of Anesthesiology,  University of Lübeck, Lübeck,  Germany.
Hauke
H
Paarmann
Thorsten
T
Hanke
Matthias
M
Heringlake
Hermann
H
Heinze
Sebastian
S
Brandt
Kirk
K
Brauer
Jan
J
Karsten
Julika
J
Schön
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060666:Airway Extubation / Q000009:adverse effects* / Q000379:methods; D000758:Anesthesia / Q000379:methods*; D002545:Brain Ischemia / Q000209:etiology* / Q000378:metabolism; D006348:Cardiac Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism*; D010101:Oxygen Consumption / Q000502:physiology*; D011379:Prognosis; D011446:Prospective Studies; D019265:Spectroscopy, Near-Infrared; D013997:Time Factors; D055815:Young Adult
D010100:Oxygen