EARLY EXTUBATION OF THE TRACHEA AFTER REPAIR OF SECUNDUM-TYPE ATRIAL SEPTAL-DEFECTS IN CHILDREN

被引:23
作者
BURROWS, FA
TAYLOR, RH
HILLIER, SC
机构
[1] UNIV TORONTO,TORONTO M5S 1A1,ONTARIO,CANADA
[2] HOSP SICK CHILDREN,DEPT PAEDIAT CARDIOL,TORONTO M5G 1X8,ONTARIO,CANADA
[3] HOSP SICK CHILDREN,RES INST,TORONTO M5G 1X8,ONTARIO,CANADA
来源
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE | 1992年 / 39卷 / 10期
关键词
HEART; CONGENITAL DEFECTS; ATRIAL SEPTAL DEFECT; INTUBATION; TRACHEAL;
D O I
10.1007/BF03008372
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
To investigate the role of anaesthetic management in early extubation of the trachea in children after closure of a secundum-type atrial septal defect (ASD II), a retrospective chart review for a two-year period was performed. We identified 36 children who underwent surgical repair of an isolated ASD II. In 19 children (53%) the tracheas were extubated in the operating room immediately after surgery and in 17 patients (47%) the tracheas remained intubated and the lungs were ventilated in the Intensive Care Unit. There was no difference in age (69.5 +/- 33.8 vs 72.9 +/- 45.0 mo) or weight (19.5 +/- 8.1 versus 20.5 +/- 12.7 kg) between the two groups (mean +/- SD). Children in the extubated group had a shorter duration of cardiopulmonary bypass (43.4 +/- 7.8 min) than those remaining intubated (31.7 +/- 12.7 min) (P < 0.05). The children whose tracheas were extubated early received a lower perioperative fentanyl dose (5.9 +/-4 mug . kg-1) than those remaining intubated (35.1 +/- 8.5 mug . kg-1). Those children in the extubated group had a lower hourly requirement for morphine by infusion (13.6 +/-.7 vs 18.2 +/- 5.4 mug . kg-1 . hr-1) and a shorter stay (20.5 +/- 3.7 versus 29.0 +/- 11.2 hr) in the Intensive Care Unit. Re-intubation of the trachea was not required in any of the children and no deaths occurred. Early extubation after ASD II repair is safe and, given the results of this study, may offer certain advantages over prolonged intubation and ventilation in these children.
引用
收藏
页码:1041 / 1044
页数:4
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