Document Detail


The benefits and new predictors of early extubation following coronary artery bypass grafting.
MedLine Citation:
PMID:  10748358     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: This study researched cardiorespiratory effects and cost-effectiveness of early extubation in patients following coronary artery bypass grafting. METHODS: We retrospectively examined the character of 86 (38 preoperative, 12 intraoperative, 36 postoperative) variables in 78 patients after coronary artery bypass grafting (CABG) at our hospital. The patients were classified into three groups according to the time of extubation: Group A (less than 8 hours), Group B (8 to 24 hours) and Group C (24 hours or more). RESULTS: There were 43 patients in Group A (55%), 27 patients in Group B (35%), and 8 patients in Group C (10%). Univariate preoperative analysis revealed several differences between Groups A and B: 15 variables were found to reach statistical significance. Stepwise logistic regression analysis implicated decreased forced expiratory volume rate in the first second (FEV1.0%), postoperative cardiac index (CI) after admission to the intensive care unit (ICU) and usage of postoperative temporary pace-makers as predictors of late extubation. Also, there was a statistical significance in usage of diuretics within the first day (15.8+/-11.6 vs 28.8+/-22.6 mg; p = 0.044) and in the ICU days (3.6+/-0.8 vs 4.2+/-1.0; p = 0.004) between early and late extubation groups. CONCLUSIONS: Early extubation within 8 hours into the ICU stay was accomplished in 55% of the patients in this study. We speculate that the benefits of early extubation contain improvement of cardiac function, reduction in respiratory infection and complications, and cost saving as the result of diminished ICU admission. Also, we have shown that decreased FEV1.0%, decreased CI and the usage of a postoperative temporary pacemaker were independent predictors of prolonged intubation in our study.
Authors:
T Miyamoto; T Kimura; T Hadama
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia     Volume:  6     ISSN:  1341-1098     ISO Abbreviation:  Ann Thorac Cardiovasc Surg     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-04-28     Completed Date:  2000-04-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9703158     Medline TA:  Ann Thorac Cardiovasc Surg     Country:  JAPAN    
Other Details:
Languages:  eng     Pagination:  39-45     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic Surgery, Shinbeppu Hospital, Beppu.
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MeSH Terms
Descriptor/Qualifier:
Aged
Case-Control Studies
Coronary Artery Bypass*
Female
Hemodynamics / physiology
Humans
Intensive Care Units
Intubation, Intratracheal*
Logistic Models
Male
Postoperative Period
Respiration, Artificial
Retrospective Studies
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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