Article

lock Open Access lock Peer-Reviewed

2

Views

ORIGINAL ARTICLE

Early extubation ¡n pediatric cardiac surgery: proceedings and results in six years experience

José Augusto Báucia; Miguel Barbero-Marcial

DOI: 10.1590/S0102-76381992000300009

ABSTRACT

Of 441 pediatric patients recovering from surgical repair of congenital heart disease, 372 (84%) were extubated in the operating room immediately after the procedure, using a clinical criteria, cutaneous pO2 saturation and pCO2 in exchanged air. Postoperative complications were not correlated with the procedure, and less pulmonary complications were observed. We concluded that most of pediatric patients, including many of those with complex lesions and preoperative pulmonary hipertension, can safely be extubated early cardiac surgery with minimization of pulmonary complications secondary to mechanical ventilation as well as reduced length of ICU and hospitalary stay, minimizing children and parents stress and hospitalary cost.

RESUMO

De 441 crianças portadoras de cardiopatias congênitas submetidas a intervenções cirúrgicas, 372 (84%) foram extubadas em sala cirúrgica, imediatamente após o procedimento baseado em critérios clínicos, saturação cutânea de O2 e pCO2 no ar expirado. As complicações pós-operatórias não apresentaram correlação com o procedimento, observando-se, inclusive, baixo índice de complicações pulmonares. Concluiu-se que a maioria das crianças, incluindo muitas com lesões complexas e hipertensão pulmonar pre-operatoria, podem ser extubadas precocemente com segurança e diminuição das complicações pulmonares secundárias à ventilação mecânica, bem como redução do período de permanência em UTI, e de hospitalização, stress da criança, dos familiares e os custos hospitalares.
Full text available only in portuguese PDF format.

REFERENCES

1. AYROSA-GALVÃO, P. C.; GONZAGA, R. L.; MITRE, N. - Heart surgery in children: postoperative in a general intensive care unit. Rev. Bras. Terap. Intens., 3 (Supl. I): 122, 1991.

2. BARASH, P. G.; LESCOVICH, F.; KATZ, J. D.; TALNER, N. S.; STANSEL Jr., H. C. - Early extubation following pediatric cardiothoracic operation: a viable alternative. Ann. Thorac. Surg., 29: 228-233, 1980. [MedLine]

3. CONNELL, R. S.; PAGE, V. S.; BARTLEY, T. D.; BIGELOW, J. C.; WEEB, M. C. - The effect on pulmonary ultrastructure of Dacron-Wool filtration during cardiopulmonary bypass. Ann. Thorac. Surg., 15: 217-229, 1973. [MedLine]

4. FREIRE SOBRINHO, A.; BAUCIA, J. A.; TRANQUITELLE, A. M.; NAKAGAWA, N. K.; BARBERO-MARCIAL, M. - Cirurgia cardíaca infantil em hospital geral: procedimentos e resultados em 5 anos de experiencia. Arq. Bras. Cardiol, (No prelo). [MedLine]

5. HEARD, G. G.; LAMBERT Jr., J. J.; PARK, S. M.; WALDMAN, J. D.; WALDMAN, J. - Early extubation after surgical repairy of congenital heart disease. Crit. Care Med., 13: 830-836, 1986.

6. LICHTENTHAL, P. R.; WADE, L. D.; NIEMYSKI, P. R. - Respiratory management after cardiac surgery with Inhalation-anesthesia. Crit. Care Med., 11: 603-609, 1983.

7. PRAKASH, O.; JOHNSON, B.; MEIJI, S.; BOS, E.; HUGENHOLTZ, P. G.; NAUTA, J.; HEKMAN, W. - Criteria for early extubation after intracardiac surgery in adults. Anesth. Analg., 59: 703-708, 1977.

8. QUASHA, A. C.; LEOBER, N.; FEELEY, T. W.; ULLYOT, D. J.; ROIZEN, M. F. Postoperative respiratory care: a controlled trial of early and late extubation following coronary-artery bypass grafting. Anesthesiology, 52: 135-141, 1980. [MedLine]

9. RABELO, R. C.; OLIVEIRA, S. A.; TANAKA, H.; WEIGL, D. R.; VERGINELLI, G.; ZERBINI, E. J. - The influence of the nature of the prime on postperfusion pulmonary changes. J. Thorac. Cardiovasc. Surg., 66: 782, 1973. [MedLine]

10. RATLIFF, N. B.; YOUNG, W. G.; HACKEL, D. B.; MIKAT, E.; WILSON, W. - Pulmonary injury secondary to extracorporeal circulation: an ultrastructural study. J. Thorac. Cardiovasc. Surg., 65: 425-432, 1973. [MedLine]

Article receive on Wednesday, October 14, 1992

CCBY All scientific articles published at www.bjcvs.org are licensed under a Creative Commons license

Indexes

All rights reserved 2017 / © 2024 Brazilian Society of Cardiovascular Surgery DEVELOPMENT BY