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Early Extubation Following Coronary Artery Bypass Surgery : A Prospective Randomized Controlled Trial

Brendan S. Silbert; John D. Santamaria; Jennifer L. O'Brien; Carolyn M. Blyth; William J. Kelly; Rowan R. Molnar; Fast Track Cardiac Care Team
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From the Departments of Anaesthesia and Intensive Care, St. Vincent's Hospital, Melbourne, Victoria, Australia

From the Departments of Anaesthesia and Intensive Care, St. Vincent's Hospital, Melbourne, Victoria, Australia


From the Departments of Anaesthesia and Intensive Care, St. Vincent's Hospital, Melbourne, Victoria, Australia

1998 by the American College of Chest Physicians


Chest. 1998;113(6):1481-1488. doi:10.1378/chest.113.6.1481
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Abstract

Study objectives: To determine the safety of early extubation (EE) after coronary artery surgery.

Design: Prospective randomized controlled trial.

Setting: The cardiac surgery operating room and ICU of a university-affiliated teaching hospital.

Patients: One hundred eligible patients presenting for elective coronary artery surgery.

Interventions: Patients randomized to the EE group were administered a reduced dose of fentanyl (15 µg/kg) and an anesthetic compatible with EE, while patients randomized to the conventional extubation (CE) group were given fentanyl (50 µg/kg).

Measurements and results: The time to extubation in the EE group (median, 240 min; range, 30 to 930 min) was significantly less than the CE group (median, 420 min; range, 125 to 1,140 min) (p<0.01). Twenty patients were withdrawn from the study according to protocol guidelines. There were no cases of reintubation or complications attributable to EE.

Conclusions: By using an appropriate anesthetic technique and postoperative management, EE can be achieved following coronary artery bypass surgery without major complications.


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