Author + information
Some institutions have adopted a strategy of early extubation following heart surgery supposing that this approach might improve outcomes. To date, however, the impact of early extubation on patient outcomes is poorly understood.
We analyzed the 2011 data from the Virtual PICU system, which is a prospective multicenter registry of intensive care admissions. Data regarding post-operative ventilation for complete repair of 4 index cardiac procedures; 1) tetralogy of Fallot (TOF), 2) isolated coarctation of the aorta (coarct), 3) isolated ventricular septal defect (VSD) and 4) transposition of the great arteries (TGA). Early extubation was defined as extubation in the operating room or within 6 hours of admission to ICU. The relationship early extubation and ICU length of stay was analyzed. Results: In 2011 there were 1918 post-operative admission following 4 index procedures (table). In multivariate analysis early extubation was associated with mean reduction in ICU length of stay of 1.5 days (p=.003) Reintubation within 48hrs of early extubation occurred in 1.5% of subjects and did not differ based upon early extubation.
Early extubation following infant heart surgery is associated with a shorter ICU length of stay and no increase in reintubation rates. Efforts to extend this strategy should be considered.
|TOF n=454||VSD n-740||Coarct n=291||TGA n=231|
|Median ventilation (hrs)||24.0||20.0||36.0||93.6|
|% Early extubation||17.8%||10.4%||23.5%||5.2%|
|ICU length of stay (days) w/early extubation||3.8||1.9||3.0||4.6|
|ICU length of stay (days) w/o early extubation||4.9||3.9||6.1||10.8|
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Congenital Cardiology Solutions: Congenital Heart Surgery
Abstract Category: 13. Congenital Cardiology Solutions: Pediatri
Presentation Number: 1205M-136
- 2013 American College of Cardiology Foundation