Determinants of immediate extubation in the operating room after total thoracoscopic closure of congenital heart defects

A.-L. Yu, X.-Z. Cai, X.-J. Gao, Z.-W. Zhang, Zeng-Shan Ma, Longle Ma, Lexin Wang

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Abstract

OBJECTIVE: This study was designed to assess the factors that influence immediate extubation following totally thoracoscopic closure of congenital heart defects.SUBJECTS AND METHODS: Clinical and operational data of 216 patients (87 males, average age 13.6 ± 10.9 years) were retrospectively analyzed. Atrial (ASD, n = 90) or ventricular septal defects (VSD, n = 126) were closed via a totally thoracoscopic approach. Ultra-fast-track anesthesia (UFTA) was used in all patients.RESULTS: Immediate extubation in the operating room was successfully performed in 156 (72.2%) patients. A delayed extubation was completed in the intensive care unit in the remaining 60 (27.8%) patients. There was no significant difference in the age, sex, body weight, or type of congenital heart defect between the immediate and delayed extubation groups (p > 0.05). However, more patients in the delayed extubation group had severe preoperational pulmonary hypertension [8 (13.3%) vs. 4 (2.3%), p < 0.05]. The cardiopulmonary bypass time, aortic clamp time, and total duration of the surgery in the immediate extubation group were shorter than in the delayed extubation group (p < 0.05). Multivariate logistic regression analysis showed that preoperational pulmonary hypertension, duration of the surgery or cardiopulmonary bypass, and dosage of fentanyl used during the surgery were independent predictors for immediate extubation.CONCLUSIONS: UFTA and immediate extubation in the operating room was feasible and safe in the majority of patients undergoing totally thoracoscopic closure of ASD or VSD. Preoperational pulmonary hypertension, duration of the surgery, and the dosage of fentanyl used for UFTA were the determining factors for immediate extubation.
Original languageEnglish
Pages (from-to)234-238
Number of pages5
JournalMedical Principles and Practice
Volume22
Issue number3
DOIs
Publication statusPublished - Mar 2013

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Congenital Heart Defects
Operating Rooms
Pulmonary Hypertension
Anesthesia
Fentanyl
Cardiopulmonary Bypass
Somatotypes
Ventricular Heart Septal Defects
Intensive Care Units
Logistic Models
Body Weight
Regression Analysis

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Yu, A.-L. ; Cai, X.-Z. ; Gao, X.-J. ; Zhang, Z.-W. ; Ma, Zeng-Shan ; Ma, Longle ; Wang, Lexin. / Determinants of immediate extubation in the operating room after total thoracoscopic closure of congenital heart defects. In: Medical Principles and Practice. 2013 ; Vol. 22, No. 3. pp. 234-238.
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abstract = "OBJECTIVE: This study was designed to assess the factors that influence immediate extubation following totally thoracoscopic closure of congenital heart defects.SUBJECTS AND METHODS: Clinical and operational data of 216 patients (87 males, average age 13.6 {\~A}‚± 10.9 years) were retrospectively analyzed. Atrial (ASD, n = 90) or ventricular septal defects (VSD, n = 126) were closed via a totally thoracoscopic approach. Ultra-fast-track anesthesia (UFTA) was used in all patients.RESULTS: Immediate extubation in the operating room was successfully performed in 156 (72.2{\%}) patients. A delayed extubation was completed in the intensive care unit in the remaining 60 (27.8{\%}) patients. There was no significant difference in the age, sex, body weight, or type of congenital heart defect between the immediate and delayed extubation groups (p > 0.05). However, more patients in the delayed extubation group had severe preoperational pulmonary hypertension [8 (13.3{\%}) vs. 4 (2.3{\%}), p < 0.05]. The cardiopulmonary bypass time, aortic clamp time, and total duration of the surgery in the immediate extubation group were shorter than in the delayed extubation group (p < 0.05). Multivariate logistic regression analysis showed that preoperational pulmonary hypertension, duration of the surgery or cardiopulmonary bypass, and dosage of fentanyl used during the surgery were independent predictors for immediate extubation.CONCLUSIONS: UFTA and immediate extubation in the operating room was feasible and safe in the majority of patients undergoing totally thoracoscopic closure of ASD or VSD. Preoperational pulmonary hypertension, duration of the surgery, and the dosage of fentanyl used for UFTA were the determining factors for immediate extubation.",
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Determinants of immediate extubation in the operating room after total thoracoscopic closure of congenital heart defects. / Yu, A.-L.; Cai, X.-Z.; Gao, X.-J.; Zhang, Z.-W.; Ma, Zeng-Shan; Ma, Longle; Wang, Lexin.

In: Medical Principles and Practice, Vol. 22, No. 3, 03.2013, p. 234-238.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Determinants of immediate extubation in the operating room after total thoracoscopic closure of congenital heart defects

AU - Yu, A.-L.

AU - Cai, X.-Z.

AU - Gao, X.-J.

AU - Zhang, Z.-W.

AU - Ma, Zeng-Shan

AU - Ma, Longle

AU - Wang, Lexin

N1 - Imported on 12 Apr 2017 - DigiTool details were: month (773h) = March, 2013; Journal title (773t) = Medical Principles and Practice. ISSNs: 1011-7571;

PY - 2013/3

Y1 - 2013/3

N2 - OBJECTIVE: This study was designed to assess the factors that influence immediate extubation following totally thoracoscopic closure of congenital heart defects.SUBJECTS AND METHODS: Clinical and operational data of 216 patients (87 males, average age 13.6 ± 10.9 years) were retrospectively analyzed. Atrial (ASD, n = 90) or ventricular septal defects (VSD, n = 126) were closed via a totally thoracoscopic approach. Ultra-fast-track anesthesia (UFTA) was used in all patients.RESULTS: Immediate extubation in the operating room was successfully performed in 156 (72.2%) patients. A delayed extubation was completed in the intensive care unit in the remaining 60 (27.8%) patients. There was no significant difference in the age, sex, body weight, or type of congenital heart defect between the immediate and delayed extubation groups (p > 0.05). However, more patients in the delayed extubation group had severe preoperational pulmonary hypertension [8 (13.3%) vs. 4 (2.3%), p < 0.05]. The cardiopulmonary bypass time, aortic clamp time, and total duration of the surgery in the immediate extubation group were shorter than in the delayed extubation group (p < 0.05). Multivariate logistic regression analysis showed that preoperational pulmonary hypertension, duration of the surgery or cardiopulmonary bypass, and dosage of fentanyl used during the surgery were independent predictors for immediate extubation.CONCLUSIONS: UFTA and immediate extubation in the operating room was feasible and safe in the majority of patients undergoing totally thoracoscopic closure of ASD or VSD. Preoperational pulmonary hypertension, duration of the surgery, and the dosage of fentanyl used for UFTA were the determining factors for immediate extubation.

AB - OBJECTIVE: This study was designed to assess the factors that influence immediate extubation following totally thoracoscopic closure of congenital heart defects.SUBJECTS AND METHODS: Clinical and operational data of 216 patients (87 males, average age 13.6 ± 10.9 years) were retrospectively analyzed. Atrial (ASD, n = 90) or ventricular septal defects (VSD, n = 126) were closed via a totally thoracoscopic approach. Ultra-fast-track anesthesia (UFTA) was used in all patients.RESULTS: Immediate extubation in the operating room was successfully performed in 156 (72.2%) patients. A delayed extubation was completed in the intensive care unit in the remaining 60 (27.8%) patients. There was no significant difference in the age, sex, body weight, or type of congenital heart defect between the immediate and delayed extubation groups (p > 0.05). However, more patients in the delayed extubation group had severe preoperational pulmonary hypertension [8 (13.3%) vs. 4 (2.3%), p < 0.05]. The cardiopulmonary bypass time, aortic clamp time, and total duration of the surgery in the immediate extubation group were shorter than in the delayed extubation group (p < 0.05). Multivariate logistic regression analysis showed that preoperational pulmonary hypertension, duration of the surgery or cardiopulmonary bypass, and dosage of fentanyl used during the surgery were independent predictors for immediate extubation.CONCLUSIONS: UFTA and immediate extubation in the operating room was feasible and safe in the majority of patients undergoing totally thoracoscopic closure of ASD or VSD. Preoperational pulmonary hypertension, duration of the surgery, and the dosage of fentanyl used for UFTA were the determining factors for immediate extubation.

KW - Open access version available

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DO - 10.1159/000345844

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SP - 234

EP - 238

JO - Medical Principles and Practice

JF - Medical Principles and Practice

SN - 1011-7571

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