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Factors associated with early extubation after superior cavopulmonary connection: analysis from single ventricle reconstruction trial.
Acta Anaesthesiol Scand. 2017 Aug; 61(7):722-729.AA

Abstract

BACKGROUND

To evaluate the landscape of early extubation, and identify factors associated with early extubation (≤ 24 h) after superior cavopulmonary connection (stage 2 operation) among children with single ventricle anatomy.

METHODS

Patients undergoing stage 2 operation after Norwood operation from the Pediatric Heart Network Single Ventricle Reconstruction (SVR) trial public-use dataset were included. Elastic net regularized logistic regression models were fitted to evaluate the factors associated with early extubation after stage 2 operation.

RESULTS

In total, 390 patients from 15 North American centers qualified for inclusion. Of these, 42 patients (10.8%) were extubated in operating room, 151 patients (38.7%) were extubated outside the operating room within the first 24 h after stage 2 operation, and the remaining 197 patients (50.5%) required mechanical ventilation for > 24 h. In adjusted models, factors associated with early extubation after stage 2 operation were elective timing of stage 2 operation, lower incidence of post-Norwood complications, shorter CPB duration for stage 2 operation, and no cardiac catheterization after Stage 2 operation. We also performed multiple other alternative analyses to identify factors associated with early extubation that demonstrated same associations as the primary model. The mean hospital length of stay after Stage 2 operation was 20% shorter among patients with early extubation.

CONCLUSIONS

Data from this large multicenter study demonstrate that approximately one-half of the patients undergoing operation for superior cavopulmonary connection are extubated within 24 h after heart operation. Furthermore, early extubation is associated with shorter hospital length of stay.

Authors+Show Affiliations

Department of Pediatrics, Division of Pediatric Cardiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.Biostatistics Program, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.Biostatistics Program, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.Department of Pediatrics, Division of Pediatric Cardiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

28568112

Citation

Zakaria, D, et al. "Factors Associated With Early Extubation After Superior Cavopulmonary Connection: Analysis From Single Ventricle Reconstruction Trial." Acta Anaesthesiologica Scandinavica, vol. 61, no. 7, 2017, pp. 722-729.
Zakaria D, Rettiganti M, Gossett JM, et al. Factors associated with early extubation after superior cavopulmonary connection: analysis from single ventricle reconstruction trial. Acta Anaesthesiol Scand. 2017;61(7):722-729.
Zakaria, D., Rettiganti, M., Gossett, J. M., & Gupta, P. (2017). Factors associated with early extubation after superior cavopulmonary connection: analysis from single ventricle reconstruction trial. Acta Anaesthesiologica Scandinavica, 61(7), 722-729. https://doi.org/10.1111/aas.12915
Zakaria D, et al. Factors Associated With Early Extubation After Superior Cavopulmonary Connection: Analysis From Single Ventricle Reconstruction Trial. Acta Anaesthesiol Scand. 2017;61(7):722-729. PubMed PMID: 28568112.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors associated with early extubation after superior cavopulmonary connection: analysis from single ventricle reconstruction trial. AU - Zakaria,D, AU - Rettiganti,M, AU - Gossett,J M, AU - Gupta,P, Y1 - 2017/06/01/ PY - 2017/05/08/revised PY - 2016/11/11/received PY - 2017/05/10/accepted PY - 2017/6/2/pubmed PY - 2018/2/10/medline PY - 2017/6/2/entrez SP - 722 EP - 729 JF - Acta anaesthesiologica Scandinavica JO - Acta Anaesthesiol Scand VL - 61 IS - 7 N2 - BACKGROUND: To evaluate the landscape of early extubation, and identify factors associated with early extubation (≤ 24 h) after superior cavopulmonary connection (stage 2 operation) among children with single ventricle anatomy. METHODS: Patients undergoing stage 2 operation after Norwood operation from the Pediatric Heart Network Single Ventricle Reconstruction (SVR) trial public-use dataset were included. Elastic net regularized logistic regression models were fitted to evaluate the factors associated with early extubation after stage 2 operation. RESULTS: In total, 390 patients from 15 North American centers qualified for inclusion. Of these, 42 patients (10.8%) were extubated in operating room, 151 patients (38.7%) were extubated outside the operating room within the first 24 h after stage 2 operation, and the remaining 197 patients (50.5%) required mechanical ventilation for > 24 h. In adjusted models, factors associated with early extubation after stage 2 operation were elective timing of stage 2 operation, lower incidence of post-Norwood complications, shorter CPB duration for stage 2 operation, and no cardiac catheterization after Stage 2 operation. We also performed multiple other alternative analyses to identify factors associated with early extubation that demonstrated same associations as the primary model. The mean hospital length of stay after Stage 2 operation was 20% shorter among patients with early extubation. CONCLUSIONS: Data from this large multicenter study demonstrate that approximately one-half of the patients undergoing operation for superior cavopulmonary connection are extubated within 24 h after heart operation. Furthermore, early extubation is associated with shorter hospital length of stay. SN - 1399-6576 UR - https://www.unboundmedicine.com/medline/citation/28568112/Factors_associated_with_early_extubation_after_superior_cavopulmonary_connection:_analysis_from_single_ventricle_reconstruction_trial_ L2 - https://doi.org/10.1111/aas.12915 DB - PRIME DP - Unbound Medicine ER -