Objective: operating room (or) extubation after adult cardiac surgery with cardiopulmonary bypass cPB is rare. We examined the outcome, factors and benefits of OR extubation.Methods: We operated 60 patients in german Hospital tirana, from January 2019 to September 2020, who had undergone caBg cardiac operations: 52 patients, mitral valve repair 5 patients, aortic stenosis 1patient, Bentall procedure 1 patient, left atrial myxoma 1 patient. the patients age was from 46-82 years old, there were 24 female patients and 36 male patients, 24 diabetic patients, 36 non-diabetic patients, in all cases we did not apply epidural anesthesia. Anesthesia was used with low doses of fentanyl. in combination with propofol, sevoflurane. In all cases neostigmine was used for decurarisation.the quality and depth of anesthesia was assessed with obvious signs such as tachycardia, hypertension, sweating. endogenous stress was also assessed by monitoring glycemia during the intervention.as extubation criteria were assessed the patient’s consciousness, respiratory mechanics, hemodynamic stability, diuresis, bleeding from drains.Results: 16 patients were extubated in the or and 44 patients were extubated 15-20 minutes after the intervention in icU. there was no reintubation. 2 patients were transferred immediately from or to the repart. 35 patients were transferred to the ward 3-4 hours after extubation. 23 patients were transferred to the ward the next morning. Patients left the hospital after 5-7 days.Conclusions:extubation in the or in the early postoperative period has now become a routine in all specialized clinics. the time spent in the ICU is very low and the day spent in the ward was 5-7 days. The benefit is in the best and fastest activation of patients in the early postoperative period as well as in reduced intervention costs.
The Benefits of early Extubation in OR and ICU after Cardiac Surgery
Jacob Zeitani
2021
Abstract
Objective: operating room (or) extubation after adult cardiac surgery with cardiopulmonary bypass cPB is rare. We examined the outcome, factors and benefits of OR extubation.Methods: We operated 60 patients in german Hospital tirana, from January 2019 to September 2020, who had undergone caBg cardiac operations: 52 patients, mitral valve repair 5 patients, aortic stenosis 1patient, Bentall procedure 1 patient, left atrial myxoma 1 patient. the patients age was from 46-82 years old, there were 24 female patients and 36 male patients, 24 diabetic patients, 36 non-diabetic patients, in all cases we did not apply epidural anesthesia. Anesthesia was used with low doses of fentanyl. in combination with propofol, sevoflurane. In all cases neostigmine was used for decurarisation.the quality and depth of anesthesia was assessed with obvious signs such as tachycardia, hypertension, sweating. endogenous stress was also assessed by monitoring glycemia during the intervention.as extubation criteria were assessed the patient’s consciousness, respiratory mechanics, hemodynamic stability, diuresis, bleeding from drains.Results: 16 patients were extubated in the or and 44 patients were extubated 15-20 minutes after the intervention in icU. there was no reintubation. 2 patients were transferred immediately from or to the repart. 35 patients were transferred to the ward 3-4 hours after extubation. 23 patients were transferred to the ward the next morning. Patients left the hospital after 5-7 days.Conclusions:extubation in the or in the early postoperative period has now become a routine in all specialized clinics. the time spent in the ICU is very low and the day spent in the ward was 5-7 days. The benefit is in the best and fastest activation of patients in the early postoperative period as well as in reduced intervention costs.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
