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Very Early Extubation after Open-Heart Surgery in Children Does Not Influence Cardiac Function

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Abstract

The objective of our study was to evaluate hemodynamic effects and the cardiac function after very early extubation within the first 6 hours after open-heart surgery in children. During a 12-month period, we performed a retrospective study of 50 children (ages 3 months to 7 years) admitted to the pediatric intensive care unit immediately after minor cardiac surgery. All children were extubated within the first 6 hours after their arrival. Arterial blood and central venous pressure were monitored, and arterial blood gas analysis was performed. Cardiac index, stroke volume index, systemic vascular resistance index, and extravascular lung water index were measured by thermodilution. Early extubation of children after minor open-heart surgery with cardiopulmonary bypass is safe and does not affect cardiac functions. A slight decrease of arterial oxygen tension not resulting in respiratory or metabolic acidosis or reintubation was noted. Very early extubation in children after open-heart surgery does not promote cardiodepressive effects. It is a safe procedure that helps to reduce the unnecessary and prolonged mechanical ventilation of children after cardiopulmonary bypass surgery.

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References

  1. Barash PG, Lescovich F, Katz JD, Talner NS, Stansel HC Jr (1980) Early extubation following pediatric cardiothoracic operation: a viable alternative. Ann Thorac Surg 29:228–233

    Article  PubMed  CAS  Google Scholar 

  2. Burrows FA, Taylor RH, Hillier SC (1992) Early extubation of the trachea after repair of secundum-type atrial septal defects in children. Can Anaesth Soc J 39:1041–1044

    Article  CAS  Google Scholar 

  3. Davis S, Worley S, Mee RB, Harrison AM (2004) Factors associated with early extubation after cardiac surgery in young children. Pediatr Crit Care Med 5:63–68

    Article  PubMed  Google Scholar 

  4. Fischer JE, Allen P, Fanconi S (2000) Delay of extubation in neonates and children after cardiac surgery: impact of ventilator-associated pneumonia. Intensive Care Med 26:942–949

    Article  PubMed  CAS  Google Scholar 

  5. Gall SA, Olsen CO, McIntyre RW, et al. (1988) Beneficial effects of endotracheal extubation on ventricular performance. Implications for early extubation after cardiac operations. J Thorac Cardiovasc Surg 95(5):819–827

    PubMed  Google Scholar 

  6. George JF (1993) Invited letter concerning: cytokines and mechanisms of capillary leakage after cardiopulmonary bypass. J Thorac Cardiovasc Surg 106:566–567

    PubMed  CAS  Google Scholar 

  7. Heinle JS, Diaz LK, Fox LS (1997) Early extubation after cardiac operations in neonates and young infants. J Thorac Cardiovasc Surg 114:413–418

    Article  PubMed  CAS  Google Scholar 

  8. Khabar KS, el Barbary MA, Khouqeer F, et al. (1997) Circulating endotoxin and cytokines after cardiopulmonary bypass: differential correlation with duration of bypass and systemic inflammatory response/multiple organ dysfunction syndromes. Clin Immunol Immunopathol 85:97–103

    Article  PubMed  CAS  Google Scholar 

  9. Kloth RL, Baum VC (2002) Very early extubation in children after cardiac surgery. Crit Care Med 30:787–791

    Article  PubMed  Google Scholar 

  10. Laussen PC, Reid RW, Stene RA, et al. (1996) Tracheal extubation of children in the operating room after atrial septal defect repair as part of a clinical practice guideline. Anesth Analg 82:988–993

    Article  PubMed  CAS  Google Scholar 

  11. Penny DJ, Redington AN (1991) Doppler echocardiographic evaluation of pulmonary blood flow after the Fontan operation: the role of the lungs. Br Heart J 66:372–374

    Article  PubMed  CAS  Google Scholar 

  12. Pettersson PH, Settergren G, Owall A (2004) Similar pain scores after early and late extubation in heart surgery with cardiopulmonary bypass. J Cardiothorac Vasc Anesth 18:64–67

    Article  PubMed  Google Scholar 

  13. Pinhu L, Whitehead T, Evans T, Griffiths M (2003) Ventilator-associated lung injury. Lancet 361:332–340

    Article  PubMed  Google Scholar 

  14. Prakanrattana U, Valairucha S, Sriyoschati S, Pornvilawan S, Phanchaipetch T (1997) Early extubation following open heart surgery in pediatric patients with congenital heart diseases. J Med Assoc Thai 80:87–95

    PubMed  CAS  Google Scholar 

  15. Schmidt H, Rohr D, Bauer H, et al. (1997) Changes in intrathoracic fluid volumes during weaning from mechanical ventilation in patients after coronary artery bypass grafting. J Crit Care 12:22–27

    Article  PubMed  CAS  Google Scholar 

  16. Schuller JL, Bovill JG, Nijveld A, Patrick MR, Marcelletti C (1984) Early extubation of the trachea after open heart surgery for congenital heart disease. A review of 3 years’ experience. Br J Anaesth 56:1101–1108

    Article  PubMed  CAS  Google Scholar 

  17. Seghaye MC, Grabitz RG, Duchateau J, et al. (1996) Inflammatory reaction and capillary leak syndrome related to cardiopulmonary bypass in neonates undergoing cardiac operations. J Thorac Cardiovasc Surg 112:687–697

    Article  PubMed  CAS  Google Scholar 

  18. Shekerdemian LS, Penny DJ, Novick W (2000) Early extubation after surgical repair of tetralogy of Fallot. Cardiol Young 10:636–637

    Article  PubMed  CAS  Google Scholar 

  19. Sinzobahamvya N, Malorny SG, Brecher AM, Urban AE (1997) Prolonged endotracheal intubation after open heart surgery under the age of one year. Arch Mal Coeur Vaiss 90:1631–1636

    PubMed  CAS  Google Scholar 

  20. Tanaka K, Kumon K, Yamamoto F, et al. (1986) Respiratory care of pediatric patients requiring prolonged intubation after cardiac surgery. Crit Care Med 14:617–619

    Article  PubMed  CAS  Google Scholar 

  21. Turley K, Tyndall M, Turley K, Woo D, Mohr T (1995) Radical outcome method. A new approach to critical pathways in congenital heart disease. Circulation 92:245–249

    Google Scholar 

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Correspondence to M. Schroth.

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Meißner, U., Scharf, J., Dötsch, J. et al. Very Early Extubation after Open-Heart Surgery in Children Does Not Influence Cardiac Function. Pediatr Cardiol 29, 317–320 (2008). https://doi.org/10.1007/s00246-007-9023-0

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  • DOI: https://doi.org/10.1007/s00246-007-9023-0

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