Early extubation after cardiac operations in neonates and young infants
Early extubation after cardiac operations in neonates and young infants
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DOI：
10.1016/s0022-5223(97)70187-9
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发表时间：
1997-09-01
影响因子：
6
通讯作者：
Fox, LS
中科院分区：
文献类型：
--
作者：
Heinle, JS;Diaz, LK;Fox, LS
目的：本研究旨在探讨新生儿和小婴儿先天性心脏病术后早期拔管的可行性。方法：回顾了所有在1年内接受心脏手术的小于90日龄的患者的记录，在此期间，所有患者均作为早期拔管的潜在候选者进行管理，纳入五十六例患者，平均年龄为32 ± 31天，平均体重为3.7 ± 0.9 kg，结果：28例患者（50%）在手术室或到达重症监护室后3小时内拔管，这包括38%的小于7天的患者，50%的8 - 30天的患者，44%的31 - 60天的患者，69%的61 - 90天的患者，3例（11%）提前拔管的患者需要重新插管。没有死亡与早期拔管相关，只有1例患者受到早期拔管的负面影响，早期拔管的患者在重症监护室的停留时间较短（3.3 +/- 3.9 vs 6.7 +/- 2.9天）和更短的术后住院时间（5.9 +/- 3.3 vs 13.5 +/- 9.7天），以及较低的重症监护室（$5，851 +/-$7，225 vs $12，064 +/-$4，419）和住院总费用（21，108 +/-14，941美元vs 31，608 +/-9，861美元），结论：早期拔管可以安全地完成许多新生儿和婴幼儿接受心脏手术修复先天性心脏病，可以缩短住院时间，降低成本。
Objective: This study was undertaken to determine the feasibility of early extubation of the neonate and young infant after surgical repair of congenital heart lesions, Methods: The records of all patients less than 90 days of age who had cardiac operations over a 1-year period were reviewed, During this time, all patients were managed as potential candidates for early extubation, Fifty-six patients are included with a mean age of 32 +/- 31 days and a mean weight of 3.7 +/- 0.9 kg, Results: Twenty-eight patients (50%) were extubated in the operating room or within 3 hours after arriving in the intensive care unit, This included 38% of patients less than 7 days of age, 50% of patients 8 to 30 days of age, 44% of patients 31 to 60 days of age, and 69% of patients 61 to 90 days of age, Three patients (11%) extubated early required reintubation. No deaths were related to early extubation, Only one patient was negatively affected by early extubation, Patients extubated early had shorter stays in the intensive care unit (3.3 +/- 3.9 vs 6.7 +/- 2.9 days) and shorter postoperative hospital stays (5.9 +/- 3.3 vs 13.5 +/- 9.7 days), as well as lower intensive care unit ($5,851 +/- $7,225 vs $12,064 +/- $4,419) and total hospital ($21,108 +/- $14,941 vs $31,608 +/- $9,861) costs than patients who were ventilated, Conclusions: Early extubation can be accomplished safely in many neonates and young infants undergoing cardiac operations for repair of congenital heart defects and can shorten hospital stay and reduce costs.