Extubation in operating room versus early extubation in ICU after open-heart surgery in patients with CHDs
BACKGROUNDS AND OBJECTIVES: The "Fast track" protocol is an early extubation strategy to reduce ventilator-associated complications and induce early recovery after open-heart surgery. This study compared clinical outcomes between operating room extubation and ICU extubation after open-heart surgery in patients with CHD.
METHODS: We retrospectively reviewed 215 patients who underwent open-heart surgery for CHDs under the scheduled "Fast track" protocol between September 2016 and April 2022. The clinical endpoints were post-operative complications, including bleeding, respiratory and neurological complications, and hospital/ICU stays.
RESULTS: The patients were divided into operating room extubation (group O, n = 124) and ICU extubation (group I, n=91) groups. The most frequently performed procedures were patch closures of the atrial septal (107/215, 49.8%) and ventricular septal (89/215, 41.4%) defects. There were no significant differences in major post-operative complications or ICU and hospital stay duration between the two groups; however, patients in group I showed longer mechanical ventilatory support (0.0 min vs. 59.0 min (interquartile range: 17.0-169.0), p < 0.001). Patients in Group O showed higher initial lactate levels (3.2 ± 1.7 mg/dL versus 2.5 ± 2.0 mg/dL, p = 0.007) and more frequently used additional sedatives and opioid analgesics (33.1% versus 19.8%, p = 0.031).
CONCLUSIONS: Extubation in the operating room was not beneficial for patients during post-operative ICU or hospital stay. Early extubation in the ICU resulted in more stable hemodynamics in the immediate post-operative period and required less use of sedatives and analgesics.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:34 |
|---|---|
| Enthalten in: |
Cardiology in the young - 34(2024), 4 vom: 15. Apr., Seite 914-918 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Kim, Chan Hyeong [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
CHD |
|---|
| Anmerkungen: |
Date Completed 16.04.2024 Date Revised 16.04.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1017/S1047951123003839 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM36473390X |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM36473390X | ||
| 003 | DE-627 | ||
| 005 | 20240416232345.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1017/S1047951123003839 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1377.xml |
| 035 | |a (DE-627)NLM36473390X | ||
| 035 | |a (NLM)37981864 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Kim, Chan Hyeong |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Extubation in operating room versus early extubation in ICU after open-heart surgery in patients with CHDs |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 16.04.2024 | ||
| 500 | |a Date Revised 16.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUNDS AND OBJECTIVES: The "Fast track" protocol is an early extubation strategy to reduce ventilator-associated complications and induce early recovery after open-heart surgery. This study compared clinical outcomes between operating room extubation and ICU extubation after open-heart surgery in patients with CHD | ||
| 520 | |a METHODS: We retrospectively reviewed 215 patients who underwent open-heart surgery for CHDs under the scheduled "Fast track" protocol between September 2016 and April 2022. The clinical endpoints were post-operative complications, including bleeding, respiratory and neurological complications, and hospital/ICU stays | ||
| 520 | |a RESULTS: The patients were divided into operating room extubation (group O, n = 124) and ICU extubation (group I, n=91) groups. The most frequently performed procedures were patch closures of the atrial septal (107/215, 49.8%) and ventricular septal (89/215, 41.4%) defects. There were no significant differences in major post-operative complications or ICU and hospital stay duration between the two groups; however, patients in group I showed longer mechanical ventilatory support (0.0 min vs. 59.0 min (interquartile range: 17.0-169.0), p < 0.001). Patients in Group O showed higher initial lactate levels (3.2 ± 1.7 mg/dL versus 2.5 ± 2.0 mg/dL, p = 0.007) and more frequently used additional sedatives and opioid analgesics (33.1% versus 19.8%, p = 0.031) | ||
| 520 | |a CONCLUSIONS: Extubation in the operating room was not beneficial for patients during post-operative ICU or hospital stay. Early extubation in the ICU resulted in more stable hemodynamics in the immediate post-operative period and required less use of sedatives and analgesics | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a CHD | |
| 650 | 4 | |a early extubation | |
| 650 | 4 | |a open-heart surgery | |
| 650 | 7 | |a Hypnotics and Sedatives |2 NLM | |
| 700 | 1 | |a Lee, Jae Hong |e verfasserin |4 aut | |
| 700 | 1 | |a Kwon, Hye Won |e verfasserin |4 aut | |
| 700 | 1 | |a Cho, Sungkyu |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Woong-Han |e verfasserin |4 aut | |
| 700 | 1 | |a Ji, Sang-Hwan |e verfasserin |4 aut | |
| 700 | 1 | |a Jang, Young-Eun |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Jin-Tae |e verfasserin |4 aut | |
| 700 | 1 | |a Kwak, Jae Gun |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Cardiology in the young |d 1991 |g 34(2024), 4 vom: 15. Apr., Seite 914-918 |w (DE-627)NLM091548926 |x 1467-1107 |7 nnns |
| 773 | 1 | 8 | |g volume:34 |g year:2024 |g number:4 |g day:15 |g month:04 |g pages:914-918 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1017/S1047951123003839 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 34 |j 2024 |e 4 |b 15 |c 04 |h 914-918 | ||