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Early extubation in tetralogy of Fallot patients after complete repair

Published online by Cambridge University Press:  08 February 2011

Ranjith Baskar Karthekeyan ,
Ayya Syama Sundar ,
Sajith Sulaiman ,
Periyasamy Thangavelu ,
Mahesh Vakamudi  and
Thenali Kasianandan
Ranjith Baskar Karthekeyan*
Affiliation:
Department of Cardiac Anesthesiology, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, India
Ayya Syama Sundar
Affiliation:
Resident in Cardiac Anesthesia, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, India
Sajith Sulaiman
Affiliation:
Resident in Cardiac Anesthesia, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, India
Periyasamy Thangavelu
Affiliation:
Associate Professor in Cardiac Surgery, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, India
Mahesh Vakamudi
Affiliation:
Professor and Head, Department of Anesthesiology and Critical Care, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, India
Thenali Kasianandan
Affiliation:
Resident in Cardiac Anesthesia, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, India
*
Correspondence to: Associate Professor Ranjith Baskar Karthekeyan, Department of Cardiac Anesthesiology, Sri Ramachandra Medical College and Research Institute, no. 1, Ramachandra Nagar, Porur, Chennai 116, India. Tel: 9144 24986880, 91 9841136568; Fax: 9144 45928627; E-mail: [email protected]
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Abstract

Aim

To document the feasibility of early extubation and to know the effect of age, weight, and post-operative right ventricle/left ventricle ratio in early extubation in intracardiac repair for tetralogy of Fallot.

Materials and methods

This is a prospective study of 76 consecutive patients undergoing intracardiac repair between January, 2010 and April, 2010. The patients were compared between duration of ventilation with age, weight, and post-operative left ventricle/right ventricle ratio.

Results

In the age group less than 10 years, 47 patients were extubated within 4 hours and 12 after 4 hours. In the age group of 10–20 years, eight patients were extubated within 4 hours and seven patients after 4 hours. In the more than 20 years category, one patient was extubated within 4 hours and the other after 4 hours. In the weight category less than 10 kilograms, 17 patients were extubated within 4 hours and seven patients after 4 hours. In the 10–20 kilogram category, 27 patients were extubated before 4 hours and four patients after 4 hours. In the more than 20-kilogram category, 12 patients were extubated before 4 hours and nine patients after 4 hours. Where the ratio was less than 0.5, 47 patients were extubated within 4 hours and 14 patients after 4 hours. Where the ratio was greater than 0.5, nine patients were extubated within 4 hours and six patients after 4 hours.

Conclusion

There was no correlation between duration of ventilation with age, weight, and right ventricle/left ventricle ratio. Early extubation in patients after intracardiac repair in tetralogy of Fallot is safe and effective.

Keywords

Cyanosisfast trackcongenital
Type
Original Articles
Information
Cardiology in the Young , Volume 21 , Issue 4 , 12 July 2011 , pp. 378 - 382
Copyright
Copyright © Cambridge University Press 2011

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References

1.Kanchi, M. Fast tracking paediatric cardiac surgical patients. Ann Card Anaesth 2005; 8: 33–38.CrossRefGoogle ScholarPubMed
2.Nichols, DG, Cameron, DE, Greeley, WJ. Critical heart disease in infants and children. N Engl J Med 1995; 553–577.Google Scholar
3.Stanger, P, Lucas, RV, Edwards, JE. Anatomic factors causing respiratory distress in acyanotic congenital heart diseases. Pediatrics 1969; 43: 760–769.CrossRefGoogle Scholar
4.Berlinger, NT, Long, C, Foker, J. Tracheobronchial compression in acyanotic congenital heart disease. Ann Otol Rhinol Laryngol 1983; 92: 387–390.CrossRefGoogle ScholarPubMed
5.Christos, A, Qiang, C, Maria, G, et al. Repair of tetralogy of Fallot in infancy with a transvetricular or transatrial approach. Eur J Cardiothorac Surg 2002; 22: 174–183.Google Scholar
6.Fuster, V, Mchoon, DC, Kennedy, MA, et al. Long term evaluation of open heart surgery for tetralogy of Fallot. Am J Cardiol 1980; 40: 635–642.CrossRefGoogle Scholar
7.Hormitz, LN, Vetter, VL, Harken, AH, et al. Electrophysiological characteristics of sustained ventricular tachycardia occurring after surgical repair of tetralogy of Fallot. Am J Cardiol 1980; 46: 446–452.CrossRefGoogle Scholar
8.Papagiannis, S, Rammos, GV, Kirvassilis, GE. Early results after transatrial/transpulmonary repair of tetralogy of Fallot. Eur J Cardiothorac Surg 2002; 22: 582–586.Google Scholar
9.Sunil, KK, Sitaraman, R, Kulbhushan, SD, Parvathi, U. Significant intraoperative right ventricular outflow gradients after repair for tetralogy of Fallot: to revise or not to revise? Ann Thorac Surg 1999; 68: 1705–1713.Google Scholar
10.Halpern, NA. Federal and nationwide intensive care units and health care costs. Crit Care Med 1994; 22: 2001–2007.Google Scholar
11.Barash, PG, Lesovich, F, Katz, JD, et al. Early extubation following pediatric cardiothoracic operation: a viable alternative. Ann Thorac Surg 1980; 29: 228–233.CrossRefGoogle ScholarPubMed
12.Schuller, JL, Bovill, JG, Nijveld, A, et al. Early extubation of the trachea after open heart surgery for congenital heart disease: a review of 3 years experience. Br J Anaesth 1984; 56: 1101–1108.CrossRefGoogle ScholarPubMed
13.Heinle, SJ, Diaz, LK, Fox, LS. Early extubation after cardiac operations in neonates and young infants. J Thorac Cardiovasc Surg 1997; 114: 413–418.CrossRefGoogle ScholarPubMed
14.Shapiro, B, Lichtenthal, P. Inhalational-based anesthetic techniques are the key to early extubation of cardiac surgical patient. J Cardiothorac Vasc Anesth 1993; 7: 135–136.CrossRefGoogle Scholar
15.Quash, A, Loeber, N, Freeley, T, et al. Post respiratory care; A control trial of early and late extubation following coronary artery hypass grafting. Anesthesia 1980; 52: 135–141.Google Scholar
16.Higgans, T. Pro: early extubation is preferable to late extubation in patient following coronary artery surgery. J Cardiothorac Vasc Anesth 1992; 6: 488–493.CrossRefGoogle Scholar
17.Shekerdemain, LS, Penny, DJ, Novick, W. Earlx extubatipn after surgical repair of tetralogy of Fallot. Cardiol Young 2000; 10: 636–637.CrossRefGoogle Scholar