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Incidence of Immediate Extubation After Pediatric Cardiac Surgery and Predictors for Reintubation

Takeshi Shinkawa1, Xinyu Tang2, Jeffrey M Gossett2

  • 11 Division of Pediatric and Congenital Cardiothoracic Surgery, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

World Journal for Pediatric & Congenital Heart Surgery
|August 31, 2018
PubMed

Insights

Immediate extubation after pediatric cardiac surgery is feasible in most cases. Higher inotropic scores predict the need for reintubation in single ventricle palliation patients.

Area of Science:

  • Pediatric Cardiac Surgery
  • Anesthesiology
  • Critical Care Medicine

Background:

  • Immediate tracheal extubation in the operating room (OR) is a goal in pediatric cardiac surgery.
  • Predictors for reintubation after extubation require further investigation.

Purpose of the Study:

  • To determine the incidence of immediate tracheal extubation in the OR after pediatric cardiac surgery.
  • To identify predictors for subsequent reintubation in these patients.

Main Methods:

  • Retrospective single-institutional study (2011-2016).
  • Included patients undergoing cardiac operations with cardiopulmonary bypass.
  • Excluded patients needing preoperative ventilation, open chest, or mechanical support.
  • Subgroup analysis for stage II palliation to identify reintubation predictors.

Main Results:

  • Immediate extubation occurred in 64.9% of 909 operations.
  • Anesthesiologist, year, bypass time, and operation type influenced immediate extubation.
  • Reintubation was less frequent with immediate extubation (6.1% vs 15.0%).
  • In stage II palliation, younger age, lower blood gas values, and higher inotropic scores predicted reintubation.

Conclusions:

  • Most pediatric cardiac surgery patients can undergo immediate OR extubation.
  • Inotropic score is a significant predictor of reintubation in stage II palliation.
Abstract

Keywords:
CHDanesthesiacomplicationscongenital heart diseaseperioperative carepostoperative caresurgery

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