PMID- 34980525
OWN - NLM
STAT- MEDLINE
DCOM- 20220420
LR  - 20220420
IS  - 1532-8422 (Electronic)
IS  - 1053-0770 (Linking)
VI  - 36
IP  - 5
DP  - 2022 May
TI  - Association Between Early Extubation and Postoperative Reintubation After 
      Elective Cardiac Surgery: A Bi-institutional Study.
PG  - 1258-1264
LID - S1053-0770(21)01031-4 [pii]
LID - 10.1053/j.jvca.2021.11.027 [doi]
AB  - OBJECTIVE: It is unknown if remaining intubated after cardiac surgery is 
      associated with a decreased risk of postoperative reintubation. The primary 
      objective of this study was to investigate whether there was an association 
      between the timing of extubation and the risk of reintubation after cardiac 
      surgery. DESIGN: A retrospective, observational study. SETTING: Two 
      university-affiliated tertiary care centers. PARTICIPANTS: A total of 9,517 
      patients undergoing either isolated coronary artery bypass grafting (CABG) or 
      aortic valve replacement (AVR). INTERVENTIONS: None. MEASUREMENTS AND MAIN 
      RESULTS: A total of 6,609 isolated CABGs and 2,908 isolated AVRs were performed 
      during the study period. Reintubation occurred in 112 patients (1.64%) after CABG 
      and 44 patients (1.5%) after AVR. After multivariate logistic regression 
      analysis, early extubation (within the first 6 postoperative hours) was not 
      associated with a risk of reintubation after CABG (odds ratio [OR] 0.53, 95% CI 
      0.26-1.06) and AVR (OR 0.52, 95% CI 0.22-1.22). Risk factors for reintubation 
      included increased age in both the CABG (OR per 10-year increase, 1.63; 95% CI 
      1.28-2.08) and AVR (OR per 10-year increase, 1.50; 95% CI 1.12-2.01) cohorts. 
      Total bypass time, race, and New York Heart Association (NYHA) functional class 
      were not associated with reintubation risk. CONCLUSION: Reintubation after CABGs 
      and AVRs is a rare event, and advanced age is an independent risk factor. Risk is 
      not increased with early extubation. This temporal association and low overall 
      rate of reintubation suggest the strategies for extubation should be modified in 
      this patient population.
CI  - Copyright (c) 2021 Elsevier Inc. All rights reserved.
FAU - Brovman, Ethan Y
AU  - Brovman EY
AD  - Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and 
      Women's Hospital, Boston, MA.
FAU - Tolis, George
AU  - Tolis G
AD  - Department of Cardiac Surgery, Massachusetts General Hospital, Boston, MA.
FAU - Hirji, Sameer
AU  - Hirji S
AD  - Department of Cardiac Surgery, Brigham and Women's Hospital, Boston, MA.
FAU - Axtell, Andrea
AU  - Axtell A
AD  - Department of Cardiac Surgery, Massachusetts General Hospital, Boston, MA.
FAU - Fields, Kara
AU  - Fields K
AD  - Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and 
      Women's Hospital, Boston, MA.
FAU - Muehlschlegel, J Daniel
AU  - Muehlschlegel JD
AD  - Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and 
      Women's Hospital, Boston, MA.
FAU - Urman, Richard D
AU  - Urman RD
AD  - Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and 
      Women's Hospital, Boston, MA.
FAU - Deseda, Gaston A Cudemis
AU  - Deseda GAC
AD  - Department of Anesthesiology, Critical Care and Pain Medicine, Massachusetts 
      General Hospital, Boston, MA.
FAU - Kaneko, Tsuyoshi
AU  - Kaneko T
AD  - Department of Cardiac Surgery, Brigham and Women's Hospital, Boston, MA.
FAU - Karamnov, Sergey
AU  - Karamnov S
AD  - Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and 
      Women's Hospital, Boston, MA. Electronic address: skaramnov@bwh.harvard.edu.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20211127
PL  - United States
TA  - J Cardiothorac Vasc Anesth
JT  - Journal of cardiothoracic and vascular anesthesia
JID - 9110208
SB  - IM
CIN - J Cardiothorac Vasc Anesth. 2022 May;36(5):1505-1506. PMID: 35031220
CIN - J Cardiothorac Vasc Anesth. 2022 May;36(5):1265-1267. PMID: 35193778
MH  - Airway Extubation/adverse effects
MH  - Aortic Valve/surgery
MH  - *Cardiac Surgical Procedures/adverse effects
MH  - Coronary Artery Bypass/adverse effects
MH  - *Heart Valve Prosthesis Implantation/adverse effects
MH  - Humans
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - aortic valve replacement
OT  - cardiac anesthesia
OT  - coronary artery bypass grafting
OT  - extubation
OT  - reintubation
EDAT- 2022/01/05 06:00
MHDA- 2022/04/21 06:00
CRDT- 2022/01/04 05:56
PHST- 2021/07/12 00:00 [received]
PHST- 2021/11/15 00:00 [revised]
PHST- 2021/11/17 00:00 [accepted]
PHST- 2022/01/05 06:00 [pubmed]
PHST- 2022/04/21 06:00 [medline]
PHST- 2022/01/04 05:56 [entrez]
AID - S1053-0770(21)01031-4 [pii]
AID - 10.1053/j.jvca.2021.11.027 [doi]
PST - ppublish
SO  - J Cardiothorac Vasc Anesth. 2022 May;36(5):1258-1264. doi: 
      10.1053/j.jvca.2021.11.027. Epub 2021 Nov 27.