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Semin Cardiothorac Vasc Anesth. 2012 Dec;16(4):182-6. doi: 10.1177/1089253212451150. Epub 2012 Jul 13.

Pro: early extubation in the operating room following cardiac surgery in adults.

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University of Virginia, Charlottesville, VA, USA.


There is growing evidence that the general current approach in many centers of continued mechanical ventilation following cardiac surgery has evolved through historical experience rather than having a strong physiological basis in current practice. There is evidence going back several decades supporting very early (in the operating room [OR]) extubation in pediatric cardiac anesthesia. The authors provide evidence from numerous sources showing that extubation in the OR or shortly after arrival in the ICU is safe and cost-effective and is not prevented by the type of cardiac surgery or the use of cardiopulmonary bypass. They query if the paradigm should not be reversed and very early extubation be the routine unless contraindicated. Like any anesthetic technique, appropriate patient selection is called for, but this technique is widely appropriate.

[Indexed for MEDLINE]

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