Early tracheal extubation after coronary artery bypass graft surgery reduces costs and improves resource use: A prospective, randomized, controlled trial

Anesthesiology

Volumn 85, Issue 6, 1996, Pages 1300-1310

  Cheng, Davy C H ^a   Karski, Jacek ^b   Peniston, Charles ^b   Raveendran, Ganesh ^b   Asokumar, Buvanendran ^b   Carroll, Jo ^b   David, Tirone ^b   Sandler, Alan ^b  

^a UNIVERSITY HEALTH NETWORK   (Canada)

^b NONE

Author keywords

Anesthesia: early extubation; Costs: saving; resource utilization; Study design: prospective randomized trial; Surgery: cardiac

Indexed keywords

ADULT; ANESTHESIOLOGICAL TECHNIQUES; ARTICLE; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; CORONARY ARTERY BYPASS GRAFT; COST BENEFIT ANALYSIS; COST CONTROL; EXTUBATION; FEMALE; HEALTH CARE COST; HEALTH CARE SYSTEM; HEALTH CARE UTILIZATION; HEALTH ECONOMICS; HEART SURGERY; HOSPITAL ADMISSION; HOSPITAL DISCHARGE; HOSPITALIZATION; HUMAN; MAJOR CLINICAL STUDY; MALE; MEDICAL FEE; NURSING; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; RESOURCE MANAGEMENT;

AGED; ANESTHESIA; CORONARY ARTERY BYPASS; DIRECT SERVICE COSTS; FEMALE; HOSPITALIZATION; HUMANS; INTUBATION, INTRATRACHEAL; MALE; POSTOPERATIVE PERIOD; PROSPECTIVE STUDIES; TIME FACTORS;

EID: 0030444004     PISSN: 00033022     EISSN: None     Source Type: Journal    
DOI: 10.1097/00000542-199612000-00011     Document Type: Article

References (29)

1. Naylor CD, Ugnat AM, Weinkauf D, Anderson GM, Wielgosz A: Coronary artery bypass grafting in Canada: What is its rate of use? Which rate is right? Can Med Assoc J 1992; 146:851-9
2. Mangano DT: Perioperative Cardiac Morbidity. ANESTHESIOLOGY 1990; 72:153-84
3. Fuchs VR: The health sector's share of the gross national product. Science 1990; 247:534-8
4. Weinstein MC, Coxson PG, Williams LW, Pass TM, Stason WB, Goldman L: Forecasting coronary heart disease incidence, mortality, and cost: The coronary heart disease policy model. Am J Public Health 1987; 77:1417-26
5. Jones EL, Weintraub WS, Craver J, Guyton RA, Cohen CL: Coronary bypass surgery: Is the operation different today? J Thorac Cardiovasc Surg 1991; 101:108-15
6. Taylor GJ, Mikell FL, Moses HW, Dove JT, Katholi RE, Malik SA, Markwell SJ, Korsmeyer C, Schneider JA, Wellons HA: Determinants of hospital charges for coronary artery bypass surgery: The economic consequences of postoperative complications. Am J Cardiol 1990; 65:309-13
7. Ramsay MA, Savege TM, Simpson BR, Goodwin R: Controlled sedation with alphaxalone-alphadolone. Br Med J 1974; 2:656-9
8. Krueger H, Goncalves JL, Caruth FM, Hayden RI: Coronary artery bypass grafting: How much does it cost? Can Med Assoc J 1992; 146:163-8
9. Laupacis A, Labelle R, Goerce R, Cairns J: The cost-effectiveness of routine post-myocardial infarction exercise stress testing. Can J Cardiol 1990; 6:157-63
10. Hlatky MA, Lipscomb J, Nelson C, Califf RM, Pryor D, Wallace AG, Mark DB: Resource use and cost of initial coronary revascularization. Coronary angioplasty versus coronary bypass surgery. Circulation 1990; 82(IV):208-13
11. Cohen DJ, Breall JA, Ho KKL, Weintraub RM, Kuntz RE, Weinstein MC, Baim DS: Economics of elective coronary revascularization: Comparison of costs and charges for conventional angioplasty, directional arthrectomy, stenting and bypass surgery. J Am Coll Cardiol 1993; 22:1052-9
12. Lee TH, Goldman L: Serum enzyme assays in the diagnosis of acute myocardial infarction. Recommendations based on a quantitative analysis. Ann Intern Med 1986; 105:221-33
13. Christakis GT, Ivanov J, Weisel RD, Birnbaum PL, David TE, Salerno TA, and the Cardiovascular Surgeons of the University of Toronto: The changing pattern of coronary artery bypass surgery. Circulation 1989; 80:I 151-61
14. Harrison DC. Cost containment in medical: Why cardiology? Am J Cardiol 1985; 56:10C-15C
15. Mazer CD, Byrick RJ, Sibbald WJ, Chovaz PM, Goodman SJ, Girotti MJ, Hall JK, Pagliarello J: Postoperative utilization of critical care services by cardiac surgery: A multicenter study in the Canadian healthcare system. Crit Care Med 1993; 21:851-9
16. Reeder GS, Krishan I, Norbrega FT, Naessens J, Kelly M, Christianson JB, McAfee MK: Is percutaneous coronary angioplasty less expensive than bypass surgery? N Engl J Med 1984; 311:1157-62
17. Loop FD, Christiansen EK, Lester JL, Cosgrove DM, Franco I, Golding LR: A strategy for cost containment in coronary surgery. JAMA 1983; 250:63-6
18. Higgins TL: Pro: Early extubation is preferable to late extubation in patients undergoing coronary artery surgery. J Cardiothorac Vasc Anesth 1992; 6:488-93
19. Siliciano D: Con: Early extubation is not preferable to late extubation in patients undergoing coronary artery surgery. J Cardiothorac Vasc Anesth 1992; 6:494-8
20. Cheng DCH: Pro: Early extubation after cardiac surgery decreases intensive care unit stay and cost. J Cardiothorac Vasc Anesth 1995; 9:460-4
21. Klineberg PL, Geer RT, Hirsh RA, Aukburg SJ: Early extubation after artery bypass graft surgery. Crit Care Med 1977; 5:272-4
22. Prakash O. Jonson B, Meij S, Bos E, Hugenholtz PG, Nauta J, Hekman W: Criteria for early extubation after intra-cardiac surgery in adults. Anesth Analg 1977; 56:703-8
23. Quasha AL, Loeher N, Feeley TW, Ullyot DJ, Roizen MF: Postoperative respiratory care: A controlled trial of early and late extubation following coronary artery bypass grafting. ANESTHESIOLOGY 1980; 52:135-41
24. Foster GH, Conway WA, Pamulkov N, Lester JL, Magilligan DJ Jr: Early extubation after coronary artery bypass: A brief report. Crit Care Medicine 1984; 12:994-6
25. Westahy S, Pillai R, Parry A, O'Regan D, Giannopoulos N, Grebenik K, Sinclair M, Fisher A: Does modern cardiac surgery require conventional intensive care? Eur J Cardio-Thorac Surg 1993; 7:313-8
26. Chong JL, Grebenik C, Sinclair M, Fisher A, Pillai R, Westaby S: The effects of a cardiac surgical recovery area on the timing of extubation. J Cardiothorac Vasc Anesth 1993; 7:137-41
27. Arom KV, Emery RW, Petersen RJ, Schwartz M: Cost-effectiveness and predictors of early extubation. Ann Thorac Surg 1995; 60:127-32
28. Engelman RM, Rousou JA, Flack JE, Deaton DW, Humphrey CB, Ellison LH, Allmendinger PD, Owen SG, Pekow PS: Fast-track recovery of the coronary bypass patient. Ann Thorac Surg 1994; 58:1742-6.
29. Cheng DCH, Karski J, Peniston C, Asokumar B, Raveenclran G, Carroll J, Nierenberg H, Roger S, Mickle D, Tong J, Zelovitsky J, David T, Sandler A: Morbidity outcome in early versus conventional tracheal extubation after coronary artery bypass grafting: A prospective randomized controlled trial. J Thorac Cardiovasc Surg 1996; 112:755-64.