Ultrafast-track extubation after pediatric cardiac surgery; benefits and safety

Mohamed  Elgazzar; Mohamed  Abdelrahman; Amany  Khedr; Basem Abdelgawad

doi:10.35810/ects.v3i1.168

Mohamed Elgazzar Department of Cardiothoracic surgery, Faculty of Medicine, Benha University, Qalyobia, Egypt
Mohamed Abdelrahman Department of Anesthesia and Intensive Care, Faculty of Medicine, Benha University, Qalyobia, Egypt
Amany Khedr Department of Anesthesia and Intensive Care, Faculty of Medicine, Benha University, Qalyobia, Egypt
Basem Abdelgawad Department of Cardiothoracic surgery, Faculty of Medicine, Benha University, Qalyobia, Egypt

DOI: https://doi.org/10.35810/ects.v3i1.168

Keywords: Ultrafast-track extubation, On-table extubation, Fast-track anesthesia, Early extubation after cardiac surgery

Abstract

Background: Ultrafast-track extubation after cardiac surgery my facilitate rapid recovery. However, the overall risk-benefit is still debatable. The objective of this study was to report the effect of ultrafast-track extubation in pediatric patients undergoing cardiac surgery.

Methods: This is a retrospective study that included 260 patients who had surgery for congenital heart diseases between 2015 and 2019. Patients were divided into two groups. Group A included patients who had ultrafast-track extubation protocol (n = 140), and group B was the conventional anesthesia group (n = 120).

Results: The mean age was 3.68 ± 2.1 and 3.8 ± 1.6 years for groups A and B, respectively (p= 0.08). The total operative time was higher in group A (326± 18.15 vs. 274.6±28.1 minutes; p 0.001), and the degree of pulmonary hypertension were higher in group B (p= 0.02). The rate of ventilator-related complications was higher in group B (P = 0.02). There was a significant reduction in mean length of intensive care unit stay between the ultrafast-track extubation and the conventional groups (65.3 ± 33.7 and 81.6±70.2 hours, respectively; p= 0.001). The total hospital stay was significantly reduced in group A (6.7 ± 2.7 vs. o 7.43±2.65 days for group A and B, respectively, p= 0.03).

Conclusions: The application of ultrafast-track extubation protocol could lead to a reduction in the ventilator-related complications, the length of intensive care unit and hospital stays without increasing postoperative complications.