[Factors influencing early extubation after open heart surgery]

The authors have performed a retrospective study in order to review the occurrence and the influencing factors of early extubation among their patients. Those patients who had any severe complication in the immediate postoperative period (pericardial tamponade, low cardiac output syndrome, re-operation due to excessive bleeding, postperfusion lung syndrome, pulmonary edema) preventing early extubation, have been excluded from the study. In the remaining 690 patients early extubation within 8 hours and within 4 hours could be carried out in 525 (76.1%) and 164 cases (23.8%) respectively. Late (beyond 12 hours) extubation occurred in 68 cases (9.9%). Anaesthesia was governed by two different methods. Midazolam and alfentanyl (group 1) were used in 137 cases (19.9%) whilst 553 patients (80.1%) received propofol and alfentanyl (group 2). In group 1 and 2 early extubation was possible in 50.4 and 82.5% respectively (p < 0.0001). In further investigations 27 pre- and intraoperative variables of each patient have been studied and analysed. For statistical analysis authors used the SPSS software including T-test, Mann-Whitney-test, chi-square test and multivariate logistical regression analysis. On the basis of multivariate regression analysis factors influencing early extubation were as follows: age (B = 0.0775; p < 0.001), sex (B = 1.2900; p < 0.001), method of anaesthesia (B = 1.9753; p < 0.001), duration of anaesthesia (B = 0.0053; p < 0.001), re-do operation (B = 1.0482; p = 0.0469) and preoperative congestive heart failure (B = 0.9008; p = 0.0125). Pulmonary diseases known from patient history have not had a deep impact on early extubation. On the basis of our study early extubation has not resulted in an increased number of either the postoperative complications or the occurrence of perioperative myocardial infarction.