Extubation in the Operating Room After Fontan's Procedure: Effect on Practice and Outcomes

Predictors of Successful Early Extubation Following Congenital Cardiac Surgery in Neonates and Infants

“…In an analysis of patients extubated in the operating room immediately following a Fontan procedure, during the first 12 h postoperatively, the extubated group had lower mean pulmonary artery pressures, lower mean atrial pressures and higher mean arterial pressures than in the control group [16]. This study also detailed a lower mean duration of inotropic agents for the extubated cohort (1.1 versus 2.4 days) and shorter overall ICU and hospital stays.…”

Economic and Safety Implications of Introducing Fast Tracking in Congenital Heart Surgery

“…These findings confirm and validate reports from single-center studies 3 and mirror similar reports from adult cardiac surgery. Morales et al, 19 for example, implemented early extubation as part of a fast-tracking approach during a 5-year period in children after Fontan surgery. Hospital and ICU costs for patients who were extubated in the operating room at the end of the procedure were 31% and 35% lower, respectively, compared with costs for children who were extubated later in the ICU.…”

Cardiac intensive care for the neonate and child after cardiac surgery

“…Most clinicians strive to extubate patients who have undergone a superior cavopulmonary anastomosis or Fontan procedure relatively early, as negative pressure ventilation in these patients is associated with improved pulmonary blood flow due to decreased pulmonary artery and systemic atrial pressure, with a resultant increase in systemic cardiac output as well [62]. In addition, extubation of the Fontan patient in the operating room has been associated with decreased hospital resource utilization and recovery time, without an increase in the patient's operating room time [63].…”