Early extubation after elective surgical aortic valve replacement during the COVID-19 pandemic.
J Cardiothorac Surg
; 19(1): 490, 2024 Aug 24.
Article
em En
| MEDLINE
| ID: mdl-39180091
ABSTRACT
BACKGROUND:
Surgical aortic valve replacement (SAVR) is an established therapy for severe calcific aortic stenosis. Enhanced recovery after cardiac surgery (ERACS) protocols have been shown to improve outcomes for elective cardiac procedures. The COVID-19 pandemic prompted early extubation post-elective surgeries to preserve critical care resources. AIM OF THIS STUDY To investigate the effects of extubating patients within 6 h post-elective SAVR on hospital and ICU length of stay, mortality rates, ICU readmissions, and postoperative pneumonia. STUDY DESIGN ANDMETHODS:
The retrospective analysis at the University Hospital Aachen, Germany, includes data from 2017 to 2022 and compares a total of 73 elective SAVR patients. Among these, 23 patients were extubated within 6 h (EXT group), while 50 patients remained intubated for over 6 h (INT group).RESULTS:
The INT group experienced longer postoperative ventilation, needed more vasopressor support, had a higher incidence of postoperative pneumonia, and longer ICU length of stay. No significant differences were noted in overall hospital length of stay, mortality, or ICU readmission rates between the groups.CONCLUSION:
This study demonstrates that early extubation in high-risk, multimorbid surgical aortic valve replacement patients is safe, and is associated with a reduction of pneumonia rates, and with shorter ICU and hospital length of stays, reinforcing the benefits of ERACS protocols, especially critical during the COVID-19 pandemic to optimize intensive care use.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Procedimentos Cirúrgicos Eletivos
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Implante de Prótese de Valva Cardíaca
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Extubação
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COVID-19
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Tempo de Internação
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article