In operating room extubation after cardiac surgery is associated with decreased incidence of in hospital new postoperative atrial fibrillation

IF 5 2区医学 Q1 ANESTHESIOLOGY

Journal of Clinical Anesthesia Pub Date : 2024-10-10 DOI:10.1016/j.jclinane.2024.111636

Ragini G. Gupta MD, Shreya Patel, Anke Wang MD, Jennie Y. Ngai MD

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引用次数: 0

Abstract

Objectives

This study aims to characterize the risks and benefits of in-OR extubation after cardiac surgery.

Design

This is a retrospective chart review.

Setting

Single tertiary care hospital.

Participants

Cardiac surgical patients >18 years. Exclusion criteria included patients extubated after 6 h in the ICU, those with a history of congenital heart disease (CHD), those intubated prior to arrival to the OR, procedures including circulatory arrest and/or selective cerebral perfusion, cardiothoracic transplantation, and intraoperative death. De-identified data was collected via the hospital's electronic medical record.

Interventions

None.

Measurements and main results

Perioperative data was collected for 726 patients, of which 303 (42 %) were extubated in the OR. Multivariable regression models were derived with covariates based on expert clinical reasoning. When compared to fast track extubation, in-OR extubation was independently associated with decreased index hospitalization length of stay (−1.74, 95 % CI [−2.22, −1.08], p < 0.001) and decreased incidence of in-hospital new post-operative atrial fibrillation (OR 0.56 95 % CI [0.37, 0.86], p < 0.01). There were no differences in persistent vasoactive therapy requirement, postoperative mechanical circulatory support or extubation failure.

Conclusions

In-OR extubation is associated with decreased index hospitalization length of stay and decreased new onset in-hospital atrial fibrillation.

查看原文本刊更多论文

心脏手术后在手术室拔管与降低术后新发心房颤动的发生率有关。

研究目的本研究旨在描述心脏手术后室内拔管的风险和益处：这是一项回顾性病历审查：参与者：年龄大于 18 岁的心脏手术患者：年龄大于18岁的心脏手术患者。排除标准包括：在 ICU 拔管 6 小时后的患者、有先天性心脏病（CHD）病史的患者、到达手术室前插管的患者、包括循环停止和/或选择性脑灌注在内的手术、心胸移植以及术中死亡的患者。通过医院的电子病历收集去身份化数据：干预措施：无：收集了 726 名患者的围手术期数据，其中 303 人（42%）在手术室拔管。根据专家的临床推理，利用协变量建立了多变量回归模型。与快速通道拔管相比，手术室内拔管与指标住院时间的缩短独立相关（-1.74，95 % CI [-2.22，-1.08]，p 结论：手术室内拔管与指标住院时间的缩短相关（-1.74，95 % CI [-2.22，-1.08]，p）：OR内拔管与缩短住院时间和减少新发院内心房颤动有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Anesthesia 医学-麻醉学

CiteScore

7.40

自引率

4.50%

发文量

346

审稿时长

23 days

期刊介绍： The Journal of Clinical Anesthesia (JCA) addresses all aspects of anesthesia practice, including anesthetic administration, pharmacokinetics, preoperative and postoperative considerations, coexisting disease and other complicating factors, cost issues, and similar concerns anesthesiologists contend with daily. Exceptionally high standards of presentation and accuracy are maintained. The core of the journal is original contributions on subjects relevant to clinical practice, and rigorously peer-reviewed. Highly respected international experts have joined together to form the Editorial Board, sharing their years of experience and clinical expertise. Specialized section editors cover the various subspecialties within the field. To keep your practical clinical skills current, the journal bridges the gap between the laboratory and the clinical practice of anesthesiology and critical care to clarify how new insights can improve daily practice.