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Early Extubation after Heart Surgery in New Tertiary Centre: Our Experience

Dharmendra Kumar Srivastava , Dharmendra Kumar Srivastava* , Bhuwan Tiwari** , S.S. Nath*** , Lata Khatnani**** , Om Prkash Sanjeev***** , S.S. Rajput******

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Journal of Cardiovascular Medicine and Surgery 3(1):p 19-24, Jan-June 2017. | DOI: http://dx.doi.org/10.21088/jcms.2454.7123.3117.3

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Abstract

 In the modern era, main emphasis has been placed on reducing the length of ICU stay without compromising quality of care in cardiac surgery; only early extubation protocol can meet expectations of today’s heart surgery patients. In our prospective study we used multidisciplinary protocols for early extubation after heart surgery of 89 patients from May 2016 to December 2016. The patients were divided into two groups: Group A, those extubated within six hours of surgery (76.4% cases); Group B, those not extubated after six hours and electively ventilated overnight (23.5% cases). There was no significant difference in age, BSA, preoperative risk factors and left ventricular function in both groups, while female (71.4%) in group B had delayed extubation. Mean total CPB and cross clamp time in group B (187.14 & 139 minutes respectively) was higher than in group A (139.45 & 102.62 minutes respectively). In comparison of postoperative data we found that use of blood products, re-exploration for bleeding (19%) stay in ICU and step down was slightly higher in group B. High inotropic support (42.85%), deep coma (25%) were the two main factors for delayed extubation in our study. Hospital mortality was higher in group B (33.3%) than in group A (2.94%) patients. Due to successful early extubation, it is now common practice to aggressively wean and extubate in most of the patients after cardiac surgery.

 

 

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DOI: http://dx.doi.org/10.21088/jcms.2454.7123.3117.3

Keywords

Cardiopulmonary Bypass; Extubation; Neurological Status; Bleeding.

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