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Erschienen in: Pediatric Cardiology 7/2016

06.06.2016 | Original Article

Predictors of Early Extubation After Pediatric Cardiac Surgery: A Single-Center Prospective Observational Study

verfasst von: Çağlar Ödek, Tanıl Kendirli, Tayfun Uçar, Ayhan Yaman, Ercan Tutar, Zeynep Eyileten, Mehmet Taşar, Mehmet Ramoğlu, Can Ateş, Adnan Uysalel, Erdal İnce, Semra Atalay

Erschienen in: Pediatric Cardiology | Ausgabe 7/2016

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Abstract

This prospective, observational, single-center study aimed to determine the perioperative predictors of early extubation (<24 h after cardiac surgery) in a cohort of children undergoing cardiac surgery. Children aged between 1 month and 18 years who were consecutively admitted to pediatric intensive care unit after cardiac surgery for congenital heart disease between January 2012 and June 2014. Ninety-nine patients were qualified for inclusion during the study period. The median duration of mechanical ventilation was 20 h (range 1–480), and 64 patients were extubated within 24 h. Four of them failed the initial attempt at extubation, and the success rate of early extubation was 60.6 %. Older patient age (p = .009), greater body weight (p = .009), absence of preoperative pulmonary hypertension (p = .044), lower RACHS-1 category (OR, 3.8; 95 % CI 1.35–10.7; p < .05), shorter cardiopulmonary bypass (p = .008) and cross-clamp (p = .022) times, lower PRISM III-24 (p < .05) and PELOD (p < .05) scores, lower inotropic score (p < .05) and vasoactive-inotropic score (p < .05), and lower number of organ failures (OR, 2.26; 95 % CI 1.30–3.92; p < .05) were associated with early extubation. Our study establishes that early extubation can be accomplished within the first 24 h after surgery in low- to medium-risk pediatric cardiac surgery patients, especially in older ones undergoing low-complexity procedures. A large prospective multiple institution trial is necessary to identify the predictors and benefits of early extubation and to facilitate defined guidelines for early extubation.
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Metadaten
Titel
Predictors of Early Extubation After Pediatric Cardiac Surgery: A Single-Center Prospective Observational Study
verfasst von
Çağlar Ödek
Tanıl Kendirli
Tayfun Uçar
Ayhan Yaman
Ercan Tutar
Zeynep Eyileten
Mehmet Taşar
Mehmet Ramoğlu
Can Ateş
Adnan Uysalel
Erdal İnce
Semra Atalay
Publikationsdatum
06.06.2016
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 7/2016
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-016-1423-6

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