Tracheal extubation of children in the operating room after atrial septal defect repair as part of a clinical practice guideline

Anesthesia and Analgesia
P C LaussenM D Freed

Abstract

Early tracheal extubation in the operating room after atrial septal defect (ASD) surgery was recommended as part of a clinical practice guideline (CPG) established in the Cardiovascular Program at the Children's Hospital, Boston, MA. This retrospective review was undertaken to determine whether this practice was efficient without compromising patient care. The charts and hospital charges for 102 patients undergoing secundum ASD or sinus venosus defect surgery between March 1992 and July 1994 were reviewed; 36 patients (Group I) had surgery prior to introduction of the CPG, and 66 patients were managed according to the CPG. Of the latter, 25 patients (Group II) were tracheally extubated in the operating room (OR) and 41 patients (Group III) were extubated in the cardiac intensive care unit (CICU). Patients in all three groups were similar with respect to height, weight, and surgical conditions including cardiopulmonary bypass time, lowest esophageal temperature, hematocrit, total OR time, and the time from completion of bypass to leaving the OR. Patients in Group II received significantly less fentanyl during anesthesia, were more likely to have a respiratory acidosis on admission to the CICU, and had an increased frequency of v...Continue Reading

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Citations

Dec 15, 2005·Heart, Lung & Circulation·Rodolfo A NeirottiGwen Paxson Fosse
Jul 22, 1998·Paediatric Anaesthesia·W S SchechterE Delphin
May 3, 2000·Paediatric Anaesthesia·C L Lake
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