Factors associated with early extubation after pediatric cardiac surgery

Abstract

Objectives: The early extubation of pediatric patients after cardiac surgery has become a contemporary trend. We aimed to determine which factors are associated with earlier extubation at our institution. Methods: We retrospectively reviewed a database of 395 infants and children who entered the pediatric ICU after cardiac surgery between January 2006 and December 2008. Patients were assigned to groups that had been extubated ≤3 hr (n = 219, 55.4%) and >3 hr (n = 176, 44.6%) of admission. Background and therapeutic factors associated with extubation ≤3 hr of admission were assessed using univariate and multivariate analyses. Results: Multiple logistic regression analysis revealed that body weight (P = 0.005), Risk Adjustment for Congenital Heart Surgery (RACHS) -1 category (P = 0.0001), and intra-operative fentanyl dose (P < 0.0001) were significantly associated with earlier extubation. The incidence of reintubation and respiratory complications were 0.5% and 4.6%, respectively, when patients were extubated ≤3 hr of admission. Conclusions: Extubation at ≤3 hr after admission was associated with body weight, cardiac procedure, and intraoperative fentanyl dose. The incidence of reintubation and respiratory complications were low when patients were extubated ≤3 hr of admission.