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Related Concept Videos

Endotracheal Tube Extubation01:24

Endotracheal Tube Extubation

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Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
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Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
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Aneurysm IV: Nursing Management01:22

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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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Tracheostomy Suctioning II: Procedure01:23

Tracheostomy Suctioning II: Procedure

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Tracheostomy suctioning is a vital nursing procedure that involves removing secretions from the tracheostomy tube to maintain airway patency and prevent respiratory complications. Nurses need to understand the proper technique for tracheostomy suctioning to ensure patient safety and comfort. In this guide, we will outline the step-by-step process for performing tracheostomy suctioning, including preparing the sterile field, donning personal protective equipment (PPE), lubricating and connecting...
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Tracheostomy Suctioning I: Pre-Procedural Steps01:26

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Tracheostomy suctioning is a critical procedure healthcare professionals perform to maintain a patent airway in patients with a tracheostomy tube. This procedure is necessary when secretions accumulate in the airway, causing respiratory distress. Here is a step-wise procedural guide for performing tracheostomy suctioning using an open system.
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First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...
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Tracheostomy Decannulation01:21

Tracheostomy Decannulation

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Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
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Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
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Endotracheal Intubation I: Procedure01:15

Endotracheal Intubation I: Procedure

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Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
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Related Experiment Video

Updated: Apr 11, 2026

Author Spotlight: Advancing Awake Nasotracheal Intubation with Flexible Video Rhino-Laryngoscopes
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Author Spotlight: Advancing Awake Nasotracheal Intubation with Flexible Video Rhino-Laryngoscopes

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Pushing the envelope: Routine operating room extubation in aortic surgery.

Michael Salna1, Katherine Phillips1, Liliya Pospishil2

  • 1Department of Cardiothoracic Surgery, NYU Grossman School of Medicine, NYU Langone Health, New York, NY.

JTCVS Open
|April 10, 2026
PubMed
Summary
This summary is machine-generated.

Extubating patients in the operating room after aortic surgery significantly reduces intensive care unit (ICU) and hospital length of stay (LOS). This practice is safe and feasible, even for complex procedures involving circulatory arrest, leading to faster recovery.

Keywords:
ERASaortic surgeryearly extubationfast track

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Area of Science:

  • Cardiovascular Surgery
  • Anesthesiology
  • Critical Care Medicine

Background:

  • Prolonged mechanical ventilation is linked to adverse patient outcomes and extended hospital stays.
  • Early extubation, particularly in the operating room (OR), is desirable for improving patient recovery.
  • Aortic surgeries, especially root and arch procedures, are complex and may necessitate circulatory arrest, raising concerns about extubation feasibility.

Purpose of the Study:

  • To assess the safety and feasibility of OR extubation following simple and complex aortic surgery.
  • To compare postoperative outcomes between patients extubated in the OR versus the intensive care unit (ICU).

Main Methods:

  • A descriptive study included consecutive patients undergoing aortic surgery between August 2023 and April 2025.
  • Patients were categorized based on extubation location: OR or ICU.
  • Evaluated 30-day postoperative outcomes, including time to chair, ICU/hospital length of stay (LOS), reintubation, and reoperation rates.

Main Results:

  • 92% of 265 patients were extubated in the OR, including those undergoing complex procedures like Bentall and total arch replacements, and those requiring circulatory arrest (91.1% extubated in OR).
  • OR extubation led to significantly earlier mobilization (3.3 hours vs. 18.6 hours to chair) and shorter ICU (7.5 hours vs. 35.6 hours) and hospital LOS (3.1 days vs. 5.8 days).
  • Thirty-day outcomes were comparable, with no deaths or myocardial infarctions; lower rates of atrial fibrillation and readmission were observed in the OR extubation group.

Conclusions:

  • Routine OR extubation is safe and feasible for a broad spectrum of aortic surgery patients, including those with complex conditions and circulatory arrest.
  • OR extubation facilitates accelerated patient recovery and earlier hospital discharge.
  • This approach does not appear to increase readmission rates or morbidity, supporting its wider adoption.