Fast tracking the paediatric cardiac surgical patient

Lake, Carol L.

doi:10.1046/j.1460-9592.2000.00521.x

Cited by 20 publications

(20 citation statements)

References 32 publications

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“…R outinely extubating patients immediately following congenital cardiac surgery is a practice that has been debated in the literature, yet remains uncommon for patients younger than 12 months [1][2][3][4][5][6]. One criticism of the existing literature is that the definition of an "early extubation" has often included patients extubated within 24 h of arrival in the ICU [7].…”

Section: Introductionmentioning

confidence: 99%

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

Winch

Nicholson

Isaacs

et al. 2009

Heart, Lung and Circulation

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Section: Introductionmentioning

confidence: 99%

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

Winch

Nicholson

Isaacs

et al. 2009

Heart, Lung and Circulation

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“…The use of the fast track approach has been encouraged for its potential benefits, especially in simple correction procedures such as interatrial communication, ventricular or persistence of arterial channel [1,4], although it can be [5].…”

Section: Discussionmentioning

confidence: 99%

“…Essential components for the execution of the system would be techniques minimally invasive, anesthetic drugs of short duration, modified ultrafiltration and transesophagic echocardiography, enabling extubation from 80 to 90% of patients [1]. The use of electroencephalogram bispectral allows the evaluation of the degree of anesthesia and, therefore, the adequate moment for extubation [3].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Extubação precoce na sala de operação após cirurgia cardíaca infantil

Abuchaim¹,

Bervanger²,

Medeiros³

et al. 2010

Rev Bras Cir Cardiovasc

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Extubação precoce na sala de operação após cirurgia cardíaca infantilEarly extubation of children in the operating room after cardiac surgery Abstract Introduction: Early extubation is related to short lenth of hospitalization and less complications.Objective: Data analisys from children extubated in the operating room after cardiac surgery with CPB.Methods: Retrospective data analisys. Results 104ABUCHAIM, DCS ET AL-Early extubation of children in the operating room after cardiac surgery Bras Cir Cardiovasc 2010; 25(1): 103-108 morphine 0.05 to 0.1 mg. The anesthesia before and after CPB was maintained by sevorane and, during CPB, by propophol. RevAfter median thoracotomy and heart exposure, it was administered a dosage of heparin 5 mg/kg, performed cannulation of the aorta and both cavas with diameters appropriate to the body surface of each patient and CPB carried out under moderate hypothermia at 25°C. The oxygenator (Edwards Life Sciences) was determined by the body surface. The cardioplegia used was the cold blood type with solution of ST Thomas (Braile Biomédica), administered in the aorta after clamping, induction dosage of 30ml/kg and repeated each 20 minutes with dosage of 20ml/kg. The hematocryt of CPB was maintained at a high level (24). The decision for extubation was made jointly by the anesthesiologist and the surgeon, at the end of thoracorraphy, individually, after evaluation of: hemodynamic stability (without vasoactive drugs), rhythm (sinus), presence of hemorrhage, cardiopathy type and age (over neonatal period).At the end of surgery, the patients were transferred to the neopediatric intensive care unit, using a Venturi oxygen mask at 50% and there were collected biochemical exams after 30 minutes of arrival.The Aristotle Score Risk was determined after filling out the clinical data in the chart available at the site www.aristotleinstitute.org [2].The statistical analysis was performed with the Student's t test, considered significant with P value lower than 0.05. RESULTSIn the period from 3/29/2006 to 1/29/2008, 70 patients aged less than 18 years of age were operated at the Hospital Santa Catarina -Blumenau, with diagnostic of congenital cardiopathy. Among these, 20 patients were submitted to procedures without CPB (ligation of arterial conduit, section of vascular ring, bandage of pulmonary artery, correction of aortic coarctation and pericardial window) and 50 patients were submitted to procedures with CPB (atriosseptoplasty, ventriculosseptoplasty, atrioventricular septal defect, Ebstein anomaly, Jatene operation, supravalvar aortic stenosis, partial septal defect, double outlet right ventricle, subaortic membrane, correction of complex cyanotic cardiopathies using procedures type modified Blalock-Taussig, Glenn or Fontan, intracardiac foreign body, Tetralogy of Fallot, cor triatriatum. Fifteen children, aged 4 to 216 months (mean 76.1 months), were submitted to extubation in the operating room after correction of congenital cardiopathies, using cardiopulmonary bypass. There were exc...

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“…In recent years, 'fast-track management' has become increasingly popular [1][2][3], with the delivery of costefficient care considered as an additional variable when measuring and comparing surgical outcomes [3]. In our institution, the fast-track approach is applied to the whole of the patient's course from admission to discharge.…”

Section: Introductionmentioning

confidence: 99%