Change in anaesthesia practice and postoperative sedation shortens ICU and hospital length of stay following coronary artery bypass surgery

We randomized prospectively 144 patients, undergoing elective coronary artery bypass surgery, to either early or to routine extubation [mechanical ventilatory support for 4–7 h (Group A), or 8–14 h (Group B)]. Anaesthesia was modified for both groups. The groups were well matched in terms of sex, ag...

Full description

Saved in:

Bibliographic Details
Published in:	Respiratory medicine Vol. 92; no. 8; pp. 1066 - 1070
Main Authors:	Michalopoulos, A., Nikolaides, A., Antzaka, C., Deliyanni, M., Smirli, A, Geroulanos, S., Papadimitriou, L.
Format:	Journal Article
Language:	English
Published:	Oxford Elsevier Ltd 01-08-1998 Elsevier
Subjects:	Aged Anesthesia, General - methods Biological and medical sciences Cardiology. Vascular system Conscious Sedation - methods Coronary Artery Bypass Coronary heart disease Critical Care - methods Female Heart Humans Intubation, Intratracheal Length of Stay Male Medical sciences Middle Aged Postoperative Care - methods Postoperative Complications Postoperative Period Prospective Studies Respiration, Artificial Human Postoperative General anesthesia Cardiovascular disease Exploration Duration Hospitalization Sedation Coronary heart disease Treatment Aortocoronary Bypass Surgery Hospital ward Early Resuscitation
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	We randomized prospectively 144 patients, undergoing elective coronary artery bypass surgery, to either early or to routine extubation [mechanical ventilatory support for 4–7 h (Group A), or 8–14 h (Group B)]. Anaesthesia was modified for both groups. The groups were well matched in terms of sex, age, NYHA class, preoperative left ventricular ejection fraction, bypass time and aortic cross-clamp time, number of grafts used, and blood units transfused. All patients had normal preoperative respiratory, renal, hepatic and cerebral functions. Mechanical ventilatory support (mean ± sd) was 6·3 ± 0·7 h for Group A and 11·6 ± 1·3 h for Group B. Mean ICU stay was 17 ± 1·3 h for Group A and 22 ± 1·2 h for Group B, while the mean hospital stay was 7·3 ± 0·8 days and 8·4 ± 0·9, respectively. There were no statistically significant differences in the frequency of all postoperative complications among the two groups. There were no reintubation, readmission to the ICU or death in either group. We concluded that change in anaesthesia practice and early postoperative sedation in patients undergoing elective coronary artery bypass graft (CABG) surgery resulted in earlier tracheal extubation, shorter ICU and hospital length of stay without organ dysfunction or postoperative complications. Early extubation was only possible due to the modification of anaesthesia and ICU sedation regime.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 ObjectType-News-3 content type line 23
ISSN:	0954-6111 1532-3064
DOI:	10.1016/S0954-6111(98)90356-0