We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Predictors of Early Extubation After Pediatric Cardiac Surgery: A Single-Center Prospective Observational Study.
- Authors
Ödek, Çağlar; Kendirli, Tanıl; Uçar, Tayfun; Yaman, Ayhan; Tutar, Ercan; Eyileten, Zeynep; Taşar, Mehmet; Ramoğlu, Mehmet; Ateş, Can; Uysalel, Adnan; İnce, Erdal; Atalay, Semra
- Abstract
This prospective, observational, single-center study aimed to determine the perioperative predictors of early extubation (<24 h after cardiac surgery) in a cohort of children undergoing cardiac surgery. Children aged between 1 month and 18 years who were consecutively admitted to pediatric intensive care unit after cardiac surgery for congenital heart disease between January 2012 and June 2014. Ninety-nine patients were qualified for inclusion during the study period. The median duration of mechanical ventilation was 20 h (range 1-480), and 64 patients were extubated within 24 h. Four of them failed the initial attempt at extubation, and the success rate of early extubation was 60.6 %. Older patient age ( p = .009), greater body weight ( p = .009), absence of preoperative pulmonary hypertension ( p = .044), lower RACHS-1 category (OR, 3.8; 95 % CI 1.35-10.7; p < .05), shorter cardiopulmonary bypass ( p = .008) and cross-clamp ( p = .022) times, lower PRISM III-24 ( p < .05) and PELOD ( p < .05) scores, lower inotropic score ( p < .05) and vasoactive-inotropic score ( p < .05), and lower number of organ failures (OR, 2.26; 95 % CI 1.30-3.92; p < .05) were associated with early extubation. Our study establishes that early extubation can be accomplished within the first 24 h after surgery in low- to medium-risk pediatric cardiac surgery patients, especially in older ones undergoing low-complexity procedures. A large prospective multiple institution trial is necessary to identify the predictors and benefits of early extubation and to facilitate defined guidelines for early extubation.
- Subjects
CARDIAC surgery; CONGENITAL heart disease in children; AIRWAY extubation; ARTIFICIAL respiration; PULMONARY hypertension; CARDIOPULMONARY bypass; PEDIATRIC surgery; PEDIATRIC cardiology
- Publication
Pediatric Cardiology, 2016, Vol 37, Issue 7, p1241
- ISSN
0172-0643
- Publication type
Article
- DOI
10.1007/s00246-016-1423-6