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Ann Thorac Surg 1980;29:228-233
© 1980 The Society of Thoracic Surgeons

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Articles

Early Extubation Following Pediatric Cardiothoracic Operation: A Viable Alternative

From the Departments of Anesthesiology, Pediatrics, and Surgery, Yale University School of Medicine, 333 Cedar St, New Haven, CT

Accepted for publication July 19, 1979.

^* Address reprint requests to Dr. Barash, Department of Anesthesiology, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510

A protocol is presented that facilitates early extubation following pediatric cardiothoracic operations. A total of 197 consecutive patients were managed according to this protocol. Fifty percent of the patients were less than 3 years old. Cardiopulmonary bypass was required in 113 (57%) of the surgical procedures. Extubation immediately following the surgical procedure was accomplished in 142 (72%) of the patients. Pulmonary complications occurred in 8 of these 142 patients (6%) and in 10 (18%) of the 55 patients requiring postoperative mechanical ventilation. Of the patients having early extubation, 5 (4%) required reintubation. One death in this group was unrelated to pulmonary function. There were 16 deaths among the 55 patients managed with mechanical ventilation. Carefully conducted early extubation provided specific advantages over routine postoperative mechanical ventilation. Modern techniques of anesthesia and surgical repair of congenital heart disease can decrease the requirement for postoperative mechanical ventilation and the potential for related complications.

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