Factors Facilitating the Success of Fast Endotracheal Extubation after Cardiac Surgery

Abstract

Objective: To study factors influencing fast endotracheal extubation after cardiac surgery. Materials and Methods: A one-year retrospective cohort study conducted via hospital medical informatics, included patients aged over 15 years old that underwent elective valvular heart surgery by means of cardiopulmonary bypass under general anesthesia. Results: Fifty-seven patients were enrolled in the present study including nine (15.8%) as fast endotracheal extubation in the operating theatre, 18 (31.6%) within eight hours postoperatively, and 30 (52.6%) non-fast endotracheal extubation eight hours after surgery. The preoperative and intraoperative factors were a younger age (p=0.018), high % left ventricular ejection function (LVEF) (p=0.023), and low creatinine level (p=0.026), as well as post cardiopulmonary bypass dexmedetomidine (p=0.01), reversal of muscle relaxant (p=0.004), and low dose dobutamine (p=0.003), respectively. However, multiple logistic regression analyses showed only two favorable factors, which were preoperative % LVEF of 60 or more (adjusted OR 11.266, 95% CI 1.700 to 74.664, p=0.012), and the intraoperative low dose dobutamine of 3 μg/kg/minute or less (adjusted OR 6.896, 95% CI 1.463 to 32.510, p=0.015). In addition, there were no significant complications. Conclusion: The factors influencing fast endotracheal extubation were preoperative% LVEF of 60 or more and intraoperative low dose dobutamine of 3 μg/kg/minute or less. Keywords: Cardiac surgery, Fast endotracheal extubation, Valvular heart disease