Assessment of the factors that affect fast-track or early extubation following pediatric cardiac surgery.

Autor:	Özalp Ş; Department of Anaesthesiology and Reanimation, Health Sciences University, Başakşehir Cam and Sakura Hospital, Istanbul, Türkiye., Dilek Özcanoğlu H; Department of Anaesthesiology and Reanimation, Health Sciences University, Başakşehir Cam and Sakura Hospital, Istanbul, Türkiye., Öztürk E; Department of Pediatric Cardiology, Health Sciences University, Başakşehir Cam and Sakura Hospital, Istanbul, Türkiye., Sağlam S; Department of Anaesthesiology and Reanimation, Health Sciences University, Başakşehir Cam and Sakura Hospital, Istanbul, Türkiye., Kahraman İA; Department of Anaesthesiology and Reanimation, Health Sciences University, Başakşehir Cam and Sakura Hospital, Istanbul, Türkiye., Tan ZB; Department of Pediatric Cardiovascular Surgery, Health Sciences University, Başakşehir Cam and Sakura Hospital, Istanbul, Türkiye., Yıldız O; Department of Pediatric Cardiovascular Surgery, Health Sciences University, Başakşehir Cam and Sakura Hospital, Istanbul, Türkiye., Özcan FG; Department of Anaesthesiology and Reanimation, Health Sciences University, Başakşehir Cam and Sakura Hospital, Istanbul, Türkiye., Hatemi AC; Department of Pediatric Cardiovascular Surgery, Health Sciences University, Başakşehir Cam and Sakura Hospital, Istanbul, Türkiye.
Jazyk:	angličtina
Zdroj:	Turk gogus kalp damar cerrahisi dergisi [Turk Gogus Kalp Damar Cerrahisi Derg] 2023 Jan 30; Vol. 31 (1), pp. 1-7. Date of Electronic Publication: 2023 Jan 30 (Print Publication: 2023).
DOI:	10.5606/tgkdc.dergisi.2023.23206
Abstrakt:	Background: This study aims to evaluate the early extubation rate and the factors affecting early extubation in pediatric patients undergoing cardiac surgery. Methods: Between August 1st, 2020 and December 1st, 2021, a total of 528 pediatric patients (264 males, 264 females; median age: 4 months; range, 2 days to 24 months) who were followed in the pediatric cardiac intensive care unit after congenital heart surgery were retrospectively analyzed. Demographic and clinical characteristics of the patients including operation and intensive care data were obtained from the medical records. Patients included in the study were categorized into three groups as the group of patients who were extubated in the operating room (fast-track extubation), the group of patients who were extubated in the first 6 h of the operation (early extubation), the group of patients who were extubated after the postoperative 6 h or the group of patients who were not extubated or died (delayed extubation). Results: Sixty-eight (12.9%) cases had fast-tract extubation, 124 (23.6%) cases had early extubation, and 335 (63.6%) cases had delayed extubation. The median age of the patients in the delayed extubation group was three months, which was significantly lower than those of the other groups (p<0.05). Reintubation rates were 1.5% in the fast-tract extubation group, 2.5% in early extubation group, and 9% in delayed extubation group (p<0.05). The median intensive care unit stay was 3, 5, and 10 days, respectively (p<0.05). Length of hospitalization was significantly higher in the delayed extubation group compared to the other groups (p<0.05). Neonatal age group, Risk Adjustment for Congenital Heart Surgery 1 score >4, Society of Thoracic Surgeons- European Association for Cardio-Thoracic Surgery mortality category >3, cardiopulmonary bypass time >100/min, vasoactive inotrope score >8, acute kidney injury >2, and low weight were found to be independent risk factors for delayed extubation. Conclusion: Fast-track and early extubation can be successfully applied with low reintubation rates in selected cases with congenital heart surgery. Age, body weight, presence of genetic syndrome, operational risk category, and procedure time may affect the extubation time. Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article. (Copyright © 2023, Turkish Society of Cardiovascular Surgery.)
Databáze:	MEDLINE
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