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J Thorac Cardiovasc Surg 1997;114:413-418
© 1997 Mosby, Inc.

SURGERY FOR CONGENITAL HEART DISEASE

EARLY EXTUBATION AFTER CARDIAC OPERATIONS IN NEONATES AND YOUNG INFANTS

Received for publication Feb. 27, 1997; revisions requested April 9, 1997; revisions received May 9, 1997; accepted for publication May 14, 1997. Address for reprints: Lawrence S. Fox, MD, Director, Pediatric Cardiovascular Surgery, Cook Children's Medical Center, 801 Seventh Ave., Fort Worth, TX 76104.

Abstract

Objective: This study was undertaken to determine the feasibility of early extubation of the neonate and young infant after surgical repair of congenital heart lesions. Methods: The records of all patients less than 90 days of age who had cardiac operations over a 1-year period were reviewed. During this time, all patients were managed as potential candidates for early extubation. Fifty-six patients are included with a mean age of 32 ± 31 days and a mean weight of 3.7 ± 0.9 kg. Results: Twenty-eight patients (50%) were extubated in the operating room or within 3 hours after arriving in the intensive care unit. This included 38% of patients less than 7 days of age, 50% of patients 8 to 30 days of age, 44% of patients 31 to 60 days of age, and 69% of patients 61 to 90 days of age. Three patients (11%) extubated early required reintubation. No deaths were related to early extubation. Only one patient was negatively affected by early extubation. Patients extubated early had shorter stays in the intensive care unit (3.3 ± 3.9 vs 6.7 ± 2.9 days) and shorter postoperative hospital stays (5.9 ± 3.3 vs 13.5 ± 9.7 days), as well as lower intensive care unit ($5,851 ± $7,225 vs $12,064 ± $4,419) and total hospital ($21,108 ± $14,941 vs $31,608 ± $9,861) costs than patients who were ventilated. Conclusions: Early extubation can be accomplished safely in many neonates and young infants undergoing cardiac operations for repair of congenital heart defects and can shorten hospital stay and reduce costs.

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