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Association Between Early Extubation and Postoperative Reintubation After Elective Cardiac Surgery: A
Ethan Y Brovman1, George Tolis2, Sameer Hirji3
1Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA.
Journal of Cardiothoracic and Vascular Anesthesia
|January 4, 2022
Summary
Early extubation after cardiac surgery is not associated with increased reintubation risk. Advanced age is a risk factor, suggesting modified extubation strategies for patients undergoing coronary artery bypass grafting and aortic valve replacement.
Area of Science:
- Cardiology
- Anesthesiology
- Thoracic Surgery
Background:
- Postoperative reintubation is a significant concern following cardiac surgery.
- The association between early extubation and reintubation risk remains unclear.
Purpose of the Study:
- To investigate the relationship between extubation timing and reintubation risk after cardiac surgery.
- To identify risk factors for reintubation in patients undergoing coronary artery bypass grafting (CABG) and aortic valve replacement (AVR).
Main Methods:
- Retrospective observational study at two tertiary care centers.
- Analysis of 9,517 patients undergoing isolated CABG or AVR.
- Multivariate logistic regression to assess the association between early extubation and reintubation.
Main Results:
- Reintubation rates were low: 1.64% after CABG and 1.5% after AVR.
- Early extubation (within 6 hours) was not associated with increased reintubation risk for either procedure.
- Increased age was identified as an independent risk factor for reintubation.
Conclusions:
- Reintubation is infrequent after CABG and AVR.
- Early extubation does not elevate reintubation risk.
- Current extubation strategies may require modification, considering age as a key risk factor.
Keywords:
aortic valve replacementcardiac anesthesiacoronary artery bypass graftingextubationreintubationMore Related Videos
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