Low preoperative cerebral oxygen saturation is associated with longer time to extubation during fast-track cardiac anaesthesia
OBJECTIVES Fast-track cardiac anaesthesia programs aiming at early tracheal extubation have not only been linked to a decrease in intensive care unit and hospital length of stay but also to a decrease in morbidity and mortality as well as a containment of rising medical costs. General recommendation...
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| Veröffentlicht in: | Interactive cardiovascular and thoracic surgery 2012-09, Vol.15 (3), p.400-405 |
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| creator | Paarmann, Hauke Hanke, Thorsten Heringlake, Matthias Heinze, Hermann Brandt, Sebastian Brauer, Kirk Karsten, Jan Schön, Julika |
| description | OBJECTIVES
Fast-track cardiac anaesthesia programs aiming at early tracheal extubation have not only been linked to a decrease in intensive care unit and hospital length of stay but also to a decrease in morbidity and mortality as well as a containment of rising medical costs. General recommendations for the inclusion criteria concerning fast-track programs are not available.
METHODS
The present study determined the factors influencing the time to extubation in patients undergoing a newly implemented fast-track protocol. Seventy-nine patients were retrospectively studied. Successful fast track was defined as time to extubation within 75 min after admission to ICU.
RESULTS
Sixty patients fulfilled the successful fast-track criteria with a mean time to extubation of 43.9 min (range 15-75 min). Nineteen patients needed more than 75 min to be weaned from the respirator with a mean time to extubation of 135 min (range 90-320 min). Analysis of pre- and intraoperative factors revealed that these groups differed only with respect to preoperative cerebral oxygen saturation levels: 67.7 ± 5.2 versus 60.8 ± 7.4%.
CONCLUSIONS
Cerebral oxygen saturation assessment prior to cardiac surgery is significantly related to time to extubation and may thus be used to stratify candidates in fast-track programs. |
| doi_str_mv | 10.1093/icvts/ivs228 |
| format | Article |
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Fast-track cardiac anaesthesia programs aiming at early tracheal extubation have not only been linked to a decrease in intensive care unit and hospital length of stay but also to a decrease in morbidity and mortality as well as a containment of rising medical costs. General recommendations for the inclusion criteria concerning fast-track programs are not available.
METHODS
The present study determined the factors influencing the time to extubation in patients undergoing a newly implemented fast-track protocol. Seventy-nine patients were retrospectively studied. Successful fast track was defined as time to extubation within 75 min after admission to ICU.
RESULTS
Sixty patients fulfilled the successful fast-track criteria with a mean time to extubation of 43.9 min (range 15-75 min). Nineteen patients needed more than 75 min to be weaned from the respirator with a mean time to extubation of 135 min (range 90-320 min). Analysis of pre- and intraoperative factors revealed that these groups differed only with respect to preoperative cerebral oxygen saturation levels: 67.7 ± 5.2 versus 60.8 ± 7.4%.
CONCLUSIONS
Cerebral oxygen saturation assessment prior to cardiac surgery is significantly related to time to extubation and may thus be used to stratify candidates in fast-track programs.</description><identifier>ISSN: 1569-9293</identifier><identifier>EISSN: 1569-9285</identifier><identifier>DOI: 10.1093/icvts/ivs228</identifier><identifier>PMID: 22691376</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Airway Extubation - adverse effects ; Airway Extubation - methods ; Anesthesia - methods ; Brain Ischemia - etiology ; Brain Ischemia - metabolism ; Cardiac Surgical Procedures ; Female ; Follow-Up Studies ; Humans ; Intensive Care Units ; Length of Stay ; Male ; Middle Aged ; Original ; Oxygen - metabolism ; Oxygen Consumption - physiology ; Prognosis ; Prospective Studies ; Spectroscopy, Near-Infrared ; Time Factors ; Young Adult</subject><ispartof>Interactive cardiovascular and thoracic surgery, 2012-09, Vol.15 (3), p.400-405</ispartof><rights>The Author 2012. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c416t-81d8cc09285d9f90c1409ba3e5019631ed21ba2cad44059ebcb4d8bba66281583</citedby><cites>FETCH-LOGICAL-c416t-81d8cc09285d9f90c1409ba3e5019631ed21ba2cad44059ebcb4d8bba66281583</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3422940/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3422940/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,1604,27923,27924,53790,53792</link.rule.ids><linktorsrc>$$Uhttps://dx.doi.org/10.1093/icvts/ivs228$$EView_record_in_Oxford_University_Press$$FView_record_in_$$GOxford_University_Press</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22691376$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Paarmann, Hauke</creatorcontrib><creatorcontrib>Hanke, Thorsten</creatorcontrib><creatorcontrib>Heringlake, Matthias</creatorcontrib><creatorcontrib>Heinze, Hermann</creatorcontrib><creatorcontrib>Brandt, Sebastian</creatorcontrib><creatorcontrib>Brauer, Kirk</creatorcontrib><creatorcontrib>Karsten, Jan</creatorcontrib><creatorcontrib>Schön, Julika</creatorcontrib><title>Low preoperative cerebral oxygen saturation is associated with longer time to extubation during fast-track cardiac anaesthesia</title><title>Interactive cardiovascular and thoracic surgery</title><addtitle>Interact Cardiovasc Thorac Surg</addtitle><description>OBJECTIVES
Fast-track cardiac anaesthesia programs aiming at early tracheal extubation have not only been linked to a decrease in intensive care unit and hospital length of stay but also to a decrease in morbidity and mortality as well as a containment of rising medical costs. General recommendations for the inclusion criteria concerning fast-track programs are not available.
METHODS
The present study determined the factors influencing the time to extubation in patients undergoing a newly implemented fast-track protocol. Seventy-nine patients were retrospectively studied. Successful fast track was defined as time to extubation within 75 min after admission to ICU.
RESULTS
Sixty patients fulfilled the successful fast-track criteria with a mean time to extubation of 43.9 min (range 15-75 min). Nineteen patients needed more than 75 min to be weaned from the respirator with a mean time to extubation of 135 min (range 90-320 min). Analysis of pre- and intraoperative factors revealed that these groups differed only with respect to preoperative cerebral oxygen saturation levels: 67.7 ± 5.2 versus 60.8 ± 7.4%.
CONCLUSIONS
Cerebral oxygen saturation assessment prior to cardiac surgery is significantly related to time to extubation and may thus be used to stratify candidates in fast-track programs.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Airway Extubation - adverse effects</subject><subject>Airway Extubation - methods</subject><subject>Anesthesia - methods</subject><subject>Brain Ischemia - etiology</subject><subject>Brain Ischemia - metabolism</subject><subject>Cardiac Surgical Procedures</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Intensive Care Units</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original</subject><subject>Oxygen - metabolism</subject><subject>Oxygen Consumption - physiology</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Spectroscopy, Near-Infrared</subject><subject>Time Factors</subject><subject>Young Adult</subject><issn>1569-9293</issn><issn>1569-9285</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kb1vFDEQxa2IiIRAlzpyBwVL_LFr1g0SihJAOilNUltje-7OZG-92N5L0uRvZ48NJ9JQzUjz05v39Ag55ewTZ1qeB7ct-TxssxDtATnmjdKVFm3zar9reUTe5PyTMa6ZZK_JkRBKc_lZHZOnRbynQ8I4YIIStkgdJrQJOhofHlfY0wxl3J1iT0OmkHN0AQp6eh_KmnaxX2GiJWyQlkjxoYx2hv2YQr-iS8ilKgncHXWQfABHoQfMZY05wFtyuIQu47vneUJury5vLr5Xi-tvPy6-LipXc1WqlvvWObaL5fVSM8drpi1IbKZISnL0glsQDnxds0ajdbb2rbWglGh508oT8mXWHUa7Qe-wnyx1ZkhhA-nRRAjm5aUPa7OKWyNrIXTNJoEPzwIp_hon-2YTssOugx7jmA1nslZNq9Xu18cZdSnmnHC5f8OZ2VVm_lRm5som_Oxfa3v4b0cT8H4G4jj8X-o32z2mVQ</recordid><startdate>20120901</startdate><enddate>20120901</enddate><creator>Paarmann, Hauke</creator><creator>Hanke, Thorsten</creator><creator>Heringlake, Matthias</creator><creator>Heinze, Hermann</creator><creator>Brandt, Sebastian</creator><creator>Brauer, Kirk</creator><creator>Karsten, Jan</creator><creator>Schön, Julika</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20120901</creationdate><title>Low preoperative cerebral oxygen saturation is associated with longer time to extubation during fast-track cardiac anaesthesia</title><author>Paarmann, Hauke ; Hanke, Thorsten ; Heringlake, Matthias ; Heinze, Hermann ; Brandt, Sebastian ; Brauer, Kirk ; Karsten, Jan ; Schön, Julika</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c416t-81d8cc09285d9f90c1409ba3e5019631ed21ba2cad44059ebcb4d8bba66281583</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Airway Extubation - adverse effects</topic><topic>Airway Extubation - methods</topic><topic>Anesthesia - methods</topic><topic>Brain Ischemia - etiology</topic><topic>Brain Ischemia - metabolism</topic><topic>Cardiac Surgical Procedures</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Intensive Care Units</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original</topic><topic>Oxygen - metabolism</topic><topic>Oxygen Consumption - physiology</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Spectroscopy, Near-Infrared</topic><topic>Time Factors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Paarmann, Hauke</creatorcontrib><creatorcontrib>Hanke, Thorsten</creatorcontrib><creatorcontrib>Heringlake, Matthias</creatorcontrib><creatorcontrib>Heinze, Hermann</creatorcontrib><creatorcontrib>Brandt, Sebastian</creatorcontrib><creatorcontrib>Brauer, Kirk</creatorcontrib><creatorcontrib>Karsten, Jan</creatorcontrib><creatorcontrib>Schön, Julika</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Interactive cardiovascular and thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Paarmann, Hauke</au><au>Hanke, Thorsten</au><au>Heringlake, Matthias</au><au>Heinze, Hermann</au><au>Brandt, Sebastian</au><au>Brauer, Kirk</au><au>Karsten, Jan</au><au>Schön, Julika</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Low preoperative cerebral oxygen saturation is associated with longer time to extubation during fast-track cardiac anaesthesia</atitle><jtitle>Interactive cardiovascular and thoracic surgery</jtitle><addtitle>Interact Cardiovasc Thorac Surg</addtitle><date>2012-09-01</date><risdate>2012</risdate><volume>15</volume><issue>3</issue><spage>400</spage><epage>405</epage><pages>400-405</pages><issn>1569-9293</issn><eissn>1569-9285</eissn><abstract>OBJECTIVES
Fast-track cardiac anaesthesia programs aiming at early tracheal extubation have not only been linked to a decrease in intensive care unit and hospital length of stay but also to a decrease in morbidity and mortality as well as a containment of rising medical costs. General recommendations for the inclusion criteria concerning fast-track programs are not available.
METHODS
The present study determined the factors influencing the time to extubation in patients undergoing a newly implemented fast-track protocol. Seventy-nine patients were retrospectively studied. Successful fast track was defined as time to extubation within 75 min after admission to ICU.
RESULTS
Sixty patients fulfilled the successful fast-track criteria with a mean time to extubation of 43.9 min (range 15-75 min). Nineteen patients needed more than 75 min to be weaned from the respirator with a mean time to extubation of 135 min (range 90-320 min). Analysis of pre- and intraoperative factors revealed that these groups differed only with respect to preoperative cerebral oxygen saturation levels: 67.7 ± 5.2 versus 60.8 ± 7.4%.
CONCLUSIONS
Cerebral oxygen saturation assessment prior to cardiac surgery is significantly related to time to extubation and may thus be used to stratify candidates in fast-track programs.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>22691376</pmid><doi>10.1093/icvts/ivs228</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Interactive cardiovascular and thoracic surgery, 2012-09, Vol.15 (3), p.400-405 |
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| source | Oxford Journals Open Access Collection |
| subjects | Adolescent Adult Aged Aged, 80 and over Airway Extubation - adverse effects Airway Extubation - methods Anesthesia - methods Brain Ischemia - etiology Brain Ischemia - metabolism Cardiac Surgical Procedures Female Follow-Up Studies Humans Intensive Care Units Length of Stay Male Middle Aged Original Oxygen - metabolism Oxygen Consumption - physiology Prognosis Prospective Studies Spectroscopy, Near-Infrared Time Factors Young Adult |
| title | Low preoperative cerebral oxygen saturation is associated with longer time to extubation during fast-track cardiac anaesthesia |
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