Efficacy of Evolving Early-Extubation Strategy on Early Postoperative Functional Recovery in Pediatric Open-Heart Surgery: A Matched Case-Control Study.
There has been a paradigm shift toward "fast-track" management with early extubation (EE) in cardiac surgery. Our retrospective, matched case-control study wishes to define the benefits of EE in pediatric congenital heart surgery. We examined 50 consecutive pediatric cardiac surgery patients extubated in the operating room (February 2009 to July 2009) against a control group of delayed-extubation patients. No significant differences were found in preoperative variables except heart failure medication. Significant intraoperative variables included the following: blood products (363 vs 487 mL, P = .023), morphine (62% vs 6%, P < .0001), and inotropes (16% vs 60%, P < .0001) given. Postoperatively significant differences included hospital stay and lower inotrope scores in the early-extubation group (14.89 vs 31.68, P < .0001). The reintubation rate was not significant. EE patients have equivalent hemodynamic profiles shown by a decreased necessity for inotropic support. We conclude that EE is feasible in low-/medium-risk pediatric congenital heart surgery patients.
UCSF, San Francisco, CA, USA barbara.hamilton@ucsfmedctr.org.
Barbara C S
BC
Hamilton
Hospital for Sick Children, Toronto, ON, Canada.
Osami
O
Honjo
King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Abdullah A
AA
Alghamdi
Hospital for Sick Children, Toronto, ON, Canada.
Christopher A
CA
Caldarone
Hospital for Sick Children, Toronto, ON, Canada.
Steven M
SM
Schwartz
Hospital for Sick Children, Toronto, ON, Canada.
Glen S
GS
Van Arsdell
Hospital for Sick Children, Toronto, ON, Canada.
Helen
H
Holtby
D060666:Airway Extubation; D006348:Cardiac Surgical Procedures; D006330:Heart Defects, Congenital / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D020127:Recovery of Function; D012189:Retrospective Studies
early extubation; fast track; pediatric congenital heart surgery