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A Structured Approach to Extubation in Mechanically Ventilated Rats
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A Structured Approach to Extubation in Mechanically Ventilated Rats

Published on: July 18, 2025

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Predictors and outcome of early extubation in infants postcardiac surgery: A single-center observational study

Shahzad Alam1, Akunuri Shalini2, Rajesh G Hegde2

  • 1Department of Pediatrics, Jawaharlal Nehru Medical College, Aligarh, Uttar Pradesh, India.

Annals of Cardiac Anaesthesia
|October 19, 2018
PubMed

Insights

Early extubation after pediatric cardiac surgery reduces intensive care unit (ICU) stay and sepsis. Predictors of prolonged ventilation include younger age, complex surgery, longer bypass/cross-clamp times, and higher inotropic scores.

Area of Science:

  • Pediatric Cardiac Surgery
  • Critical Care Medicine
  • Neonatalogy

Background:

  • Infants undergoing surgery for congenital heart disease often require prolonged mechanical ventilation.
  • Optimizing extubation timing is crucial for improving patient outcomes and resource utilization.

Purpose of the Study:

  • To evaluate the timing of first extubation in infants after cardiac surgery.
  • To compare outcomes between early and late extubation groups.
  • To identify predictors of early extubation.

Main Methods:

  • Prospective cohort study of children under 1 year old undergoing congenital heart surgery.
  • Patients were categorized based on extubation within 6 hours post-surgery.
  • Multivariate logistic regression analysis was used to identify predictors of prolonged ventilation.

Main Results:

  • No significant difference in mortality or reintubation rates between early and late extubation groups.
  • Early extubation was associated with significantly lower incidence of sepsis and shorter Pediatric Intensive Care Unit (PICU) stay.
  • Factors predicting prolonged ventilation included younger age, complex surgery, longer cardiopulmonary bypass and aortic cross-clamp times, and higher vasoactive-inotropic score.

Conclusions:

  • Early extubation in infants post-cardiac surgery is safe and beneficial, reducing PICU stay and sepsis risk.
  • Predictors of early extubation include older age, less complex procedures, shorter surgical times, and lower inotropic support requirements.
Abstract

Keywords:
Cardiac intensive careearly extubationoutcomevasoactive-inotropic score

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