Extubation in the operating room after elective on-pump CABG surgery: impact on patient outcome and clinical practice during the COVID-19 pandemic.

IF 0.7 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Anna Fischbach, Julia Alexandra Simons, Steffen Bernhard Wiegand, Celiné Lang, Rüdger Kopp, Gernot Marx, Sebastian Johannes Bauer, Patrick Winnersbach, Payam Akhyari, Gereon Schälte
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引用次数: 0

Abstract

Purpose: Coronary artery bypass graft (CABG) surgery is the standard treatment for advanced coronary artery disease. Despite evidence supporting enhanced recovery after surgery (ERAS) programs, many hospitals continue to keep patients intubated following on-pump CABG surgery. The coronavirus disease 2019 (COVID-19) pandemic further strained intensive care unit (ICU) capacities, leading to the consideration of immediate extubation after elective surgeries like CABG surgeries. The aim of this study was to assess whether extubation in the operating room after elective on-pump CABG surgery would reduce the ICU length of stay, the ICU readmission, and the ICU mortality in a population of patients undergoing on-pump CABG surgery as opposed to the conventional approach with patients remaining intubated.

Methods: This study is a retrospective single-center study, including data from the University Hospital Aachen, Germany. Clinical data from 2019 to 2022 were analyzed, focusing on patients who underwent on-pump CABG surgery. Primary endpoints studied were the duration of ICU stay, rates of ICU readmission, and ICU mortality. Secondary outcomes included the hospital length of stay, hospital mortality, and the occurrence of postoperative pneumonia.

Results: Ninety-seven patients who underwent elective on-pump CABG surgery were identified. There were no variations in outcomes, including ICU and hospital stays, mortality, ICU readmission, or postoperative pneumonia between the two groups.

Conclusion: Extubation in the operating room after on-pump CABG surgery did not result in significant differences in outcomes compared to patients who remained intubated.

Graphical abstract:

Supplementary information: The online version contains supplementary material available at 10.1007/s12055-025-01908-9.

选择性无泵冠状动脉搭桥术后拔管:COVID-19大流行期间对患者预后和临床实践的影响
目的:冠状动脉旁路移植术是晚期冠状动脉疾病的标准治疗方法。尽管有证据支持增强术后恢复(ERAS)计划,但许多医院继续让患者在无泵CABG手术后插管。2019冠状病毒病(COVID-19)大流行进一步紧张了重症监护病房(ICU)的能力,导致在CABG手术等选择性手术后考虑立即拔管。本研究的目的是评估选择性无泵CABG手术后在手术室拔管是否会减少接受无泵CABG手术的患者的ICU住院时间、ICU再入院率和ICU死亡率,而传统方法患者仍在插管。方法:本研究为回顾性单中心研究,数据来自德国亚琛大学医院。分析了2019年至2022年的临床数据,重点是接受无泵搭桥手术的患者。研究的主要终点是ICU住院时间、ICU再入院率和ICU死亡率。次要结局包括住院时间、住院死亡率和术后肺炎的发生。结果:97例患者接受了选择性无泵搭桥手术。两组之间的结果没有变化,包括ICU和住院时间、死亡率、ICU再入院或术后肺炎。结论:无泵CABG术后在手术室拔管与继续插管的患者相比,结果没有显著差异。图片摘要:补充信息:在线版本包含补充资料,可在10.1007/s12055-025-01908-9获得。
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
Indian Journal of Thoracic and Cardiovascular Surgery
Indian Journal of Thoracic and Cardiovascular Surgery CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
1.20
自引率
14.30%
发文量
141
期刊介绍: The primary aim of the Indian Journal of Thoracic and Cardiovascular Surgery is education. The journal aims to dissipate current clinical practices and developments in the area of cardiovascular and thoracic surgery. This includes information on cardiovascular epidemiology, aetiopathogenesis, clinical manifestation etc. The journal accepts manuscripts from cardiovascular anaesthesia, cardiothoracic and vascular nursing and technology development and new/innovative products.The journal is the official publication of the Indian Association of Cardiovascular and Thoracic Surgeons which has a membership of over 1000 at present.DescriptionThe journal is the official organ of the Indian Association of Cardiovascular-Thoracic Surgeons. It was started in 1982 by Dr. Solomon Victor and ws being published twice a year up to 1996. From 2000 the editorial office moved to Delhi. From 2001 the journal was extended to quarterly and subsequently four issues annually have been printed out at time and regularly without fail. The journal receives manuscripts from members and non-members and cardiovascular surgeons. The manuscripts are peer reviewed by at least two or sometimes three or four reviewers who are on the panel. The manuscript process is now completely online. Funding the journal comes partially from the organization and from revenue generated by subscription and advertisement.
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