Extubating in the operating room after adult cardiac surgery safely improves outcomes and lowers costs

Journal of Thoracic and Cardiovascular Surgery

Volumn 148, Issue 6, 2014, Pages 3101-3109.e1

  Badhwar, Vinay ^a   Esper, Stephen ^a   Brooks, Maria ^a   Mulukutla, Suresh ^a   Hardison, Regina ^a   Mallios, Demetri ^a   Chu, Danny ^a   Wei, Lawrence ^a   Subramaniam, Kathirvel ^a  

^a UNIVERSITY OF PITTSBURGH MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANGINA PECTORIS; ARTICLE; BODY MASS; CARDIAC PATIENT; COHORT ANALYSIS; ELECTIVE SURGERY; EXTUBATION; HEALTH CARE COST; HEART FAILURE; INTENSIVE CARE UNIT; LENGTH OF STAY; OPEN HEART SURGERY; OPERATING ROOM; OPERATION DURATION; POSTOPERATIVE PERIOD; SMOKING; STERNOTOMY; SURGICAL PATIENT; TREATMENT OUTCOME; UNSTABLE ANGINA PECTORIS; AGED; CHI SQUARE DISTRIBUTION; COMPARATIVE STUDY; COST BENEFIT ANALYSIS; COST CONTROL; ECONOMICS; FEMALE; HEART SURGERY; HOSPITAL COST; HUMAN; MALE; MIDDLE AGED; MULTIVARIATE ANALYSIS; PATIENT SAFETY; PROPENSITY SCORE; RETROSPECTIVE STUDY; RISK; RISK ASSESSMENT; RISK FACTOR; STATISTICAL MODEL; TIME;

AGED; AIRWAY EXTUBATION; CARDIAC SURGICAL PROCEDURES; CHI-SQUARE DISTRIBUTION; COST SAVINGS; COST-BENEFIT ANALYSIS; FEMALE; HOSPITAL COSTS; HUMANS; INTENSIVE CARE UNITS; LENGTH OF STAY; LOGISTIC MODELS; MALE; MIDDLE AGED; MULTIVARIATE ANALYSIS; ODDS RATIO; OPERATING ROOMS; PATIENT SAFETY; PROPENSITY SCORE; RETROSPECTIVE STUDIES; RISK ASSESSMENT; RISK FACTORS; TIME FACTORS; TREATMENT OUTCOME;

EID: 84919960126     PISSN: 00225223     EISSN: 1097685X     Source Type: Journal    
DOI: 10.1016/j.jtcvs.2014.07.037     Document Type: Article

References (27)

1. J.L. Trouillet, A. Combes, E. Vaissier, C.E. Luyt, A. Quattara, and A. Pavie Prolonged mechanical ventilation after cardiac surgery: outcome and predictors J Thorac Cardiovasc Surg 138 2009 948 953
2. D.C. Cheng, J. Karski, C. Peniston, B. Asokumar, G. Raveendran, and J. Carroll Morbidity outcome in early versus conventional tracheal extubation after coronary artery bypass grafting: a prospective randomized controlled trial J Thorac Cardiovasc Surg 112 1996 755 764
3. S.L.C. Reddy, A.D. Grayson, E.M. Griffiths, D.M. Pullan, and A. Rashid Logistic risk model for prolonged ventilation after adult cardiac surgery Ann Thorac Surg 84 2007 528 536
4. S. O'Brien, F.H. Edwards, V.A. Ferraris, C.K. Haan, J.B. Rich, and E.D. Peterson Quality measurement in adult cardiac surgery. Part 2: statistical considerations in composite measure scoring and provider rating Ann Thorac Surg 83 2007 S13 S26
5. D.L. Hillis, P.K. Smith, J.L. Anderson, J.A. Bittl, C.R. Bridges, and J.G. Byrne 2011 ACCF/AHA guideline for coronary artery bypass graft surgery: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines Circulation 124 2011 e652 e735
6. J. Reis, J.C. Mota, P. Ponce, A. Costa-Pereira, and M. Guerreiro Early extubation does not increase complication rates after coronary artery bypass graft surgery with cardiopulmonary bypass Eur J Cardiothorac Surg 21 2002 1026 1030
7. B.S. Silbert, J.D. Santamaria, J.L. O'Brien, C.M. Blyth, W.J. Kelly, and R.R. Molnar Early extubation following coronary artery bypass surgery: a prospective randomized controlled trial. The Fast Track Cardiac Care Team Chest 113 1998 1481 1488
8. S. Oxelbark, L. Bengtsson, M. Eggersen, J. Kopp, J. Pedersen, and R. Sanchez Fast track as a routine for open heart surgery Eur J Cardiothorac Surg 19 2001 460 463
9. C. Alhan, F. Toraman, E.H. Karabulut, S. Tarcan, S. Dagdelen, and N. Eren Fa0073t track recovery of high risk coronary bypass surgery patients Eur J Cardiothorac Surg 23 2003 678 683
10. P.S. Myles, D.J. Daly, G. Djaiani, A. Lee, and D.C. Cheng A systematic review of the safety and effectiveness of fast-track cardiac anesthesia Anesthesiology 99 2003 982 987
11. B.L. Sullivan Con: early extubation in the operating room following cardiac surgery Semin Cardiothorac Vasc Anesth 16 2012 187 189
12. D. Siliciano Con: early extubation is not preferable to late extubation in patients undergoing cardiac surgery J Cardiothorac Vasc Anesth 6 1992 494 498
13. F.R. Montes, S.I. Sanchez, J.C. Giraldo, I.E. Rincon, M.V. Vanegas, and H. Charris The lack of benefit of tracheal extubation in the operating room after coronary artery bypass surgery Anesth Analg 91 2000 776 780
14. U. Guller, K.J. Anstrom, W.L. Holman, R.M. Allman, M. Sansom, and E.D. Petersen Outcomes of early extubation after bypass surgery in the elderly Ann Thorac Surg 77 2004 781 788
15. Z.W. Fitch, O. Debesa, R. Ohkuma, D. Duquaine, J. Steppan, and E.B. Schneider A protocol-driven approach to early extubation after heart surgery J Thorac Cardiovasc Surg 147 2014 1344 1350
16. C.F. Royse, A.G. Royse, and P.F. Soeding Routine immediate extubation after cardiac operation: a review of our first 100 patients Ann Thorac Surg 68 1999 1326 1329
17. J.R. Edgerton, M.A. Herbert, S.L. Prince, J.L. Horswell, L. Michelson, and M.J. Magee Reduced atrial fibrillation in patients immediately extubated after off-pump coronary artery bypass grafting Ann Thorac Surg 81 2006 2121 2126
18. Z. Straka, P. Brucek, T. Vanek, J. Votava, and P. Widimsky Routine immediate extubation for off-pump coronary artery bypass grafting without thoracic epidural analgesia Ann Thorac Surg 74 2002 1544 1547
19. T.M. Hemmerling, N. Le, J.F. Olivier, J.L. Choiniere, F. Basile, and I. Prieto Immediate extubation after aortic valve surgery using high thoracic epidural analgesia or opioid-based analgesia J Cardiothorac Vasc Anesth 19 2005 176 181
20. G.S. Murphy, J.W. Szokol, J.H. Marymont, J.S. Vender, M.J. Avram, and T.K. Rosengart Recovery of neuromuscular function after cardiac surgery: pancuronium versus rocuronium Anesth Analg 96 2003 1301 1307
21. N.P. Dowd, J.M. Karski, D.C. Cheung, S. Gajula, P. Seneviratne, and J.A. Carroll-Munro Fast-track cardiac anesthesia in the elderly: effect of two different anesthetic techniques on mental recovery Br J Anesth 86 2001 68 76
22. A. Kilic, A.S. Shah, J.V. Conte, K. Mandal, W.A. Baumgartner, and D.E. Cameron Understanding variability in hospital-specific costs of coronary artery bypass grafting represents an opportunity for standardizing care and improving resource use J Thorac Cardiovasc Surg 147 2014 109 116
23. J.C. Chen Western Thoracic Surgical Association 2013 presidential address: winning the HITECH challenge J Thorac Cardiovasc Surg 146 2013 1006 1015
24. E.O. Ahmed, R. Butler, and R.J. Novick Failure-to-rescue rate as a measure of quality care in a cardiac surgical recovery unit: a five-year study Ann Thorac Surg 97 2014 147 152
25. D.C. Cheng, J. Karski, C. Peniston, G. Raveendran, B. Asokumar, and J. Carroll Early tracheal extubation after coronary artery bypass surgery reduces costs and improves resource use: a prospective, randomized, controlled trial Anesthesiology 85 1996 1300 1310
26. C.A. Hawkes, S. Dhileepan, and D.R. Foxcroft Early extubation for adult cardiac surgical patients Cochrane Database Syst Rev 4 2003 CD003587
27. D. Chamchad, J.C. Horrow, L. Nachamchik, F.P. Sutter, L.E. Samuels, and C.L. Trace The impact of immediate extubation in the operating room after cardiac surgery on intensive care and hospital lengths of stay J Cardiothorac Vasc Anesth 24 2010 780 784