Extubation Failure Rates After Pediatric Cardiac Surgery Vary Across Hospitals

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
Sydney R RooneyMichael Gaies

Abstract

Many hospitals aim to extubate children early after cardiac surgery, yet it remains unclear how this practice associates with extubation failure. We evaluated adjusted extubation failure rates and duration of postoperative mechanical ventilation across hospitals and assessed cardiac ICU organizational factors associated with extubation failure. Secondary analysis of the Pediatric Cardiac Critical Care Consortium clinical registry. Pediatric Cardiac Critical Care Consortium cardiac ICUs. Patients with qualifying index surgical procedures from August 2014 to June 2017. None. We modeled hospital-level adjusted extubation failure rates using multivariable logistic regression. A previously validated Pediatric Cardiac Critical Care Consortium model was used to calculate adjusted postoperative mechanical ventilation. Observed-to-expected ratios for both metrics were derived for each hospital to assess performance. Hierarchical logistic regression was used to assess the association between cardiac ICU factors and extubation failure. Overall, 16,052 surgical hospitalizations were analyzed. Predictors of extubation failure (p < 0.05 in final case-mix adjustment model) included younger age, underweight, greater surgical complexity, airway...Continue Reading

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Citations

May 7, 2019·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Warwick Butt
Jul 9, 2020·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Sydney R RooneyMichael Gaies
Oct 4, 2020·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Warwick Butt
Oct 23, 2020·Journal of Clinical Nursing·Karen B LasaterLinda H Aiken
Aug 18, 2020·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Shinya MiuraSiva P Namachivayam
Jul 19, 2020·The Journal of Thoracic and Cardiovascular Surgery·Peter C Laussen
Mar 21, 2021·Clinica Chimica Acta; International Journal of Clinical Chemistry·Nicole MüllerNoa J Freudenthal
Jul 20, 2021·World Journal for Pediatric & Congenital Heart Surgery·Orlando José Tamariz-CruzAlexis Palacios-Macedo

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