Intraoperative variables associated with extubation time in patients undergoing coronary artery bypass graft surgery

Abstract

Aim: Decreasing mechanical ventilation and early extubation in patients has many clinical and financial benefits. Therefore, an awareness of some variables those are associated with extubation time can help nurses to plan appropriate care aimed at doing an early and safe extubation. In this study, we identified whether any intraoperative variables had a significant effect on the extubation time following coronary artery bypass graft surgery. Methods: The research was conducted in a university-affiliated hospital in Tehran, Iran. In this crosssectional study, the data were collected by reviewing 93 files of eligible patients who had undergone coronary artery bypass graft surgery between December 2004 and March 2006. The data collection tool was a checklist consisting of some intraoperative variables: the number of grafts, the duration of time of the cardiopulmonary bypass and aortic cross-clamping, the use of the internal mammary artery, and the extubation time as the dependent variable. The data were analyzed by descriptive and analytical methods. Results: Extubation was achieved for 93 patients in a mean time of 7.19 Ϯ 3.00 h: 43% of the patients were extubated in Յ6 h and 57% 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 aortic cross-clamping was found to have a significant effect on the extubation time. Conclusion: This study revealed that the duration of the 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 aortic cross-clamping time might lead to earlier extubation.

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

“…Also, some variables, such as anesthetic techniques that might affect the extubation time, were dissimilar in the early and delayed extubation groups. Imanipour et al (2008), in their study, found that the CPB do not have a significant effect on the extubation time after CABG surgery (P=0.18). Maybe, this was because of the short CPB times (mean=63.73min); there was no patient with a CPB time of >120min.…”

“…4(2), pp 237-244. Available from: www.prosoc.eu are suitable for early extubation will help nurses plan appropriate care aimed at safely reducing the lenght of syat in intensive care unit and the cost associated with intubation and mechanical ventilation (Doering et al, 1998;Branca, 2001;Walthall & Ray, 2002;Imanipour et al, 2008).…”

“…Some studies have shown that the appropriate time for extubation in some cases is two to six hours after surgery; While in some it is shown to be safe between four and eight hours, the current trend is to apply within the first 12 hours after surgery (Uncu et al, 2004;Martin & Turkelson, 2006;Imanipour et al, 2008;Bowles, 2010;Roekaerts & Heijmans, 2012).…”

“…Studies have shown that factors that prolong post-operative extubation time are age, gender, operation time, minumum body temperature, cross clamp time, total perfusion time, number of bypass vessels, use of inotropic agent, amount of colloid fluid in intensive care unit, blood transfusion, hourly average urinary output to extubation, chest drainage volume, intraaortic balloon pump (IABP) usage, dose and duration of anesthesia, and partial oxygen pressure (PaO2) (Sacar et al, 2008;Imanipour et al, 2008).…”

Cardaic Surgery; Risk Factors of Delayed Extubation

“…Imanipour et al 16 also did not found any effect of pump time on delayed extubation in patients after cardiac surgery. Cislaghi et al 17 on the contrary found significant effect of pump time on duration of extubation and found that pump time more than 91 minutes is an independent risk factor of delayed extubation after cardiac surgery.…”