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Ann Thorac Surg 1995;60:132
© 1995 The Society of Thoracic Surgeons

Discussion

The first 20% of the full text of this article appears below.

	Introduction

 
See also page 127.

DR J. MARK WILLIAMS (Greenville, NC): Our group actually became interested in this issue of early extubation about 6 or 7 years ago. Because of resource limitations at that time, inability to extubate patients early and transfer them from the intensive care unit delayed or cancelled the cardiac cases the following day. The variable that had the greatest impact on early intubation in our group was the nurse who took care of the patient that evening. I noticed that this was not a variable in your analysis.

The aggressive nurse who was giving diuretics early, more rigidly following our protocol, and aggressively weaning the patient from the ventilator always resulted in early extubation. The amount or type of anesthesia given, the surgeon, or the length of the pump run did not prove to be as great a factor as the nurse taking care of the patient that evening after operation. I would suggest that you look at the nurse as one issue that can have a great impact on early . . . [Full Text of this Article]