About: Three-year experience with immediate extubation in pediatric patients after congenital cardiac surgery

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About: Three-year experience with immediate extubation in pediatric patients after congenital cardiac surgery Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Three-year experience with immediate extubation in pediatric patients after congenital cardiac surgery
Creator	Alcos, Stephen Burke, Redmond Hughes, Jessica Irizarry, Marysory Lagueruela, Richard Salyakina, Daria Tirotta, Christopher Wang, Weize
Source	PMC
abstract	BACKGROUND: In pediatric cardiac anesthesiology, there is increased focus on minimizing morbidity, ensuring optimal functional status, and using health care resources sparingly. One aspect of care that has potential to affect all of the above is postoperative mechanical ventilation. Historically, postoperative ventilation was considered a must for maintaining patient stability. Ironically, it is recognized that mechanical ventilation may increase risk of adverse outcomes in the postoperative period. Hence, many institutions have advocated for immediate extubation or early extubation after many congenital heart surgeries which was first reported decades ago. METHODS: 637 consecutive patient charts were reviewed for pediatric patients undergoing cardiac surgery with cardiopulmonary bypass. Patients were placed into three groups. Those that were extubated in the operating room (OR) at the conclusion of surgery (Immediate Extubation or IE), those that were extubated within six hours of admission to the ICU (Early Extubation or EE) and those that were extubated sometime after six hours (Delayed Extubation or DE). Multiple variables were then recorded to see which factors correlated with successful Immediate or Early Extubation. RESULTS: Overall, 338 patients (53.1%) had IE), 273 (42.8%) had DE while only 26 patients (4.1%) had EE. The median age was 1174 days for the IE patients, 39 days for the DE patients, whereas 194 days for EE patients (p < 0.001). Weight and length were also significantly different in at least one extubation group from the other two (p < 0.001). The median ICU LOS was 3 and 4 days for IE and EE patients respectively, whereas it was 9.5 days for DE patients (p < 0.001). DE group had a significant longer median anesthesia time and cardiopulmonary bypass time than the other two extubation groups (p > 63,826.88 < 0.001). Regional low flow perfusion, deep hypothermia, deep hypothermic circulatory arrest, redo sternotomy, use of other sedatives, furosemide, epinephrine, vasopressin, open chest, cardiopulmonary support, pulmonary edema, syndrome, as well as difficult intubation were significantly associated with delayed extubation (IE, EE or DE). CONCLUSIONS: Immediate and early extubation was significantly associated with several factors, including patient age and size, duration of CPB, use of certain anesthetic drugs, and the amount of blood loss and blood replacement. IE can be successfully accomplished in a majority of pediatric patients undergoing surgery for congenital heart disease, including in a minority of infants.
has issue date	2020-01-06(xsd:dateTime)
bibo:doi	10.1186/s13019-020-1051-3
bibo:pmid	31906990
has license	cc-by
sha1sum (hex)	73b9d1b4a34bcb7e716d2dfeedd4c557cba87203
schema:url	https://doi.org/10.1186/s13019-020-1051-3
resource representing a document's title	Three-year experience with immediate extubation in pediatric patients after congenital cardiac surgery
has PubMed Central identifier	PMC6945478
has PubMed identifier	31906990
schema:publication	J Cardiothorac Surg
resource representing a document's body	covid:73b9d1b4a34bcb7e716d2dfeedd4c557cba87203#body_text
is schema:about of	named entity 'epinephrine' named entity 'health care' named entity 'morbidity' named entity 'early' named entity 'operating room' named entity 'majority' named entity 'pediatric' named entity 'patients' named entity 'hypothermia' named entity 'infants' named entity 'median age' named entity 'patients' named entity 'IMMEDIATE' named entity 'DELAYED' named entity 'CARDIOPULMONARY' named entity 'CORRELATED' named entity 'LOW FLOW' named entity 'PULMONARY EDEMA' named entity 'PATIENT' named entity 'OR DE' named entity 'CARDIAC' named entity 'OPEN' named entity 'PERFUSION' named entity 'CHEST' named entity 'DIFFERENT' named entity 'INFANTS' named entity 'CARDIOPULMONARY BYPASS' named entity 'RECORDED' named entity 'EXTUBATION' named entity 'STERNOTOMY' named entity 'ASPECT' named entity 'BACKGROUND' named entity 'GROUPS' named entity 'PEDIATRIC' named entity 'WEIGHT' named entity 'FUROSEMIDE' named entity 'OVERALL' named entity 'REGIONAL' named entity 'patient' named entity 'Multiple' named entity 'One' named entity 'anesthetic' named entity 'cardiopulmonary bypass' named entity 'ICU' named entity 'sternotomy' named entity 'LOS' named entity 'Historically' named entity 'outcomes' named entity 'stability' named entity 'perfusion' named entity 'mechanical ventilation' named entity 'anesthesiology' named entity 'period' named entity 'surgery' named entity 'functional' named entity 'minority' named entity 'sedatives' named entity 'Extubation' named entity 'blood replacement' named entity 'extubation' named entity 'Extubation' named entity 'mechanical ventilation' named entity 'blood loss' named entity 'extubation' named entity 'extubation' named entity 'pulmonary edema' named entity 'deep hypothermic circulatory arrest' named entity 'pediatric patients' named entity 'congenital' named entity 'cardiac surgery' named entity 'size' named entity 'congenital heart disease' named entity 'ICU' named entity 'anesthetic'

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