Early Against Classic Extubation Outcomes Following Cardiac Surgery and Correlation With Rapid Shallow Breath Index

Abstract

Abstract

Background/Aims:Overnight postoperative ventilation following cardiovascular surgery was a routine procedure since 1960 and the usage of high-dose opioid anesthetic techniques strengthens the need. However early extubation of postcardiac patients has been claimed as safer and more cost-effective approach. Rapid shallow breath index (RSBI) is used widely to standardize weaning from Mechanical ventilatory support (MVS) and to predict failure of attempt. The aim of this retrospective study was to determine the impact of early extubation on post-cardiovasular surgery patients and the possible correlations of RSBI values. 

Methods:This retrospective analysis was performed including 230 consecutive patients -who underwent cardiac surgery from September 2017 to January 2018 in a tertiary state hospital.

Results:There was significant difference between early extubated group and conventional group in the prevalence of comorbidities, duration of surgery, LOS in hospital and in the ICU. There was no significant difference between groups either in mechanical ventilation parameters including RSBI, mortality or morbidity.

Conclusions: Early extubation offers a substantial advantage in terms of accelerated recovery, shorter intensive care unit, and hospital stay, suggesting that efforts to reduce extubation times are cost-effective. Early Extubation following cardiac surgery can be managed in a successful manner and comparing to conventional practices it saves valuable hours of patients. RSBI, in the original cut-off point, was found useless as a weaning parameter while the threshold value for weaning failure was 31. 

Keywords

• cardiac surgery,early extubation

References

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