Early extubation after coronary artery bypass: brief report

We performed a prospective study of early post-coronary artery bypass graft (CABG) ventilator management and weaning. Sixty-three patients were studied consecutively; 27 were managed by the standard post-CABG weaning practice at this institution, and 36 were managed by respiratory therapists using a protocol with specific ventilation and weaning guidelines. The mean time to extubation was decreased by 41% using the protocol. Arterial blood gas sampling was reduced 42%. There were no deaths in either group. Physicians were alerted to problems necessitating interruption of the protocol in six of 36 patients studied. This protocol proved easy to follow and safe in the hands of respiratory therapists. It lowered costs and improved patient comfort.