Intraoperative variables associated with extubation time in patients undergoing open heart surgery

Abstract

Decreasing mechanical ventilation and early extubation in patients has many clinical benefits. Hence, an awareness of some variables, associated with extubation time can help nurses to plan convenient care aimed at making a safe and early extubation. The purpose of this study was to investigate whether any intraoperative variables had a significant effect on extubation time following open heart surgery. The research was conducted on 60 open heart surgery patients who met inclusion criteria between April 2014 and November 2014 in a cardiac and vasculer surgery clinic of university hospital in Istanbul, Turkey. The data were collected by using a "Questionnaire Form" which includes some intraoperative variables (type of surgery, the number of grafts, the duration of time of the cardiopulmonary bypass, aortic crossclamping, total operation time, and the extubation time). The data was analyzed by descriptive and analytical methods. Type of the surgery procedure was 40 (66%) patients were CABG, 10 (16,6%) were valvuler surgery, 6 (10%) were ASD/VSD primer repair and 4 (3,3%) were Bentall procedure. Extubation was achieved for 60 patients in a mean time of 8.33±1.99 h. 18,3% (11) of the patients were extubated in ≤6 h and 81,7% (49) of them were extubated in >6 h after surgery, classifying them into the early and delayed extubation groups, respectively. On statistical analysis, the duration of the cardiopulmonary bypass (CPB) and aortic cross-clamping were found to have a significant effect on the extubation time.This study revealed that the duration of the cardiopulmonary bypass and aortic cross-clamping might play a role in the extubation time. Therefore, it is recommended that nurses consider this in their assessment of extubation as a shorter cardiopulmonary bypass time and aortic cross-clamping time might lead to earlier extubation.

Mobilization Levels of Cardiac Surgery Patients in the Early Postoperative Period

“…Postoperative intubation time of patients may be affected by some individual and disease characteristics. In the literature, it has been reported that age, total perfusion time, aortic cross-clamping time, total operation time, minimum body temperature, use of inotropic agents, use of intraaortic balloon pump, amount of drainage, and blood transfusion are among the factors prolonging the postoperative extubation time [9,26]. Delayed extubation may cause delayed mobilization and prolong the LOS in the ICU and hospital [1].…”

“…This form consists of some questions created by the researchers, including some demographic characteristics such as age, gender, and working time of the nurses. FORM 2: Patient Observation Form This form consists of 25 questions created by the researchers, including some demographic (13 questions) and surgical (12 questions) characteristics of patients admitted to the CVS-ICU after cardiac surgery, and IMS [9].…”