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

Year 2019, Volume: 9 Issue: 4, 332 - 337, 31.12.2019

İbrahim Mungan , Derya Ademoglu Hayriye Cankar Dal Dilek Kazancı , Sema Turan

https://doi.org/10.16899/jcm.626844

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

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