+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Evaluation of two intensive care models in relation to successful extubation after cardiac surgery



Evaluation of two intensive care models in relation to successful extubation after cardiac surgery



Medicina Intensiva 2018:



To compare outcomes between intensivist-directed and cardiac surgeon-directed care delivery models. This retrospective, historical-control study was performed in a cohort of adult cardiac surgical patients at Zhongshan Hospital (Fudan University, China). During the first phase (March to August 2015), cardiac surgeons were in charge of postoperative care while intensivists were in charge during the second phase (September 2015-June 2016). Both phases were compared regarding successful extubation rate, intensive care unit (ICU) length of stay (LOS), and in-hospital mortality. Tertiary Zhongshan Hospital (Fudan University, China). Consecutive adult patients admitted to the cardiac surgical ICU (CSICU) after heart surgery. Phase I patients treated by cardiac surgeons, and phase II patients treated by intensivists. Successful extubation, ICU LOS and in-hospital mortality. A total of 1792 (phase I) and 3007 patients (phase II) were enrolled. Most variables did not differ significantly between the two phases. However, patients in phase II had a higher successful extubation rate (99.17% vs. 98.55%; p=0.043) and a shorter median duration of mechanical ventilation (MV) (18 vs. 19h; p<0.001). In relation to patients with MV duration >48h, those in phase II had a comparatively higher successful extubation rate (p=0.033), shorter ICU LOS (p=0.038) and a significant decrease in in-hospital mortality (p=0.039). The intensivist-directed care model showed improved rates of successful extubation and shorter MV durations after cardiac surgery.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 063459571

Download citation: RISBibTeXText

PMID: 30146128

DOI: 10.1016/j.medin.2018.07.005


Related references

Con: early extubation after cardiac surgery does not decrease intensive care unit stay and cost. Journal of Cardiothoracic and Vascular Anesthesia 9(4): 465-467, 1995

Pro: early extubation after cardiac surgery decreases intensive care unit stay and cost. Journal of Cardiothoracic and Vascular Anesthesia 9(4): 460-464, 1995

The Impact of Immediate Extubation in the Operating Room After Cardiac Surgery on Intensive Care and Hospital Lengths of Stay. Yearbook of Anesthesiology and Pain Management 2012: 114-115, 2012

The impact of immediate extubation in the operating room after cardiac surgery on intensive care and hospital lengths of stay. Journal of Cardiothoracic and Vascular Anesthesia 24(5): 780-784, 2010

Cardiovascular intensive care unit utilization and service cost following early tracheal extubation practice post cardiac surgery. Anesthesia & Analgesia 80(2 Suppl. ): S72, 1995

Age influences the predictive value of Acute Physiology and Chronic Health Evaluation II and Intensive Care National Audit and Research Centre scoring models in patients admitted to Intensive Care Units after in-hospital cardiac arrest. Indian Journal of Critical Care Medicine 19(3): 155-158, 2015

A Decision for Predicting Successful Extubation of Patients in Intensive Care Unit. Biomed Research International 2018: 6820975, 2018

Anaesthesia and intensive care for cardiac surgery in France: results of the three days national survey realised in 2001 by the club of Anaesthesia, Intensive Care and Technics in Cardiac Surgery (ARTECC). Annales Francaises D'anesthesie et de Reanimation 23(9): 862-872, 2004

An Artificial Neural Network Model for Predicting Successful Extubation in Intensive Care Units. Journal of Clinical Medicine 7(9):, 2018

Role of Hematocrit Concentration on Successful Extubation in Critically Ill Patients in the Intensive Care Units. Anesthesiology and Pain Medicine 6(1): E32904, 2016

Carbapenem-resistant Enterobacteriaceae on a cardiac surgery intensive care unit: successful measures for infection control. Journal of Hospital Infection 94(1): 60-64, 2016

Predictors of successful early extubation following congenital cardiac surgery in neonates and infants. Heart Lung and Circulation 18(4): 271-276, 2009

A comparative study of four intensive care outcome prediction models in cardiac surgery patients. Journal of Cardiothoracic Surgery 6: 21, 2011

Validation of Three Postoperative Risk Prediction Models for Intensive Care Unit Mortality after Cardiac Surgery. Thoracic and Cardiovascular Surgeon 66(8): 651-660, 2018

Quality of Life in Relation to Length of Intensive Care Unit Stay After Cardiac Surgery. Journal of Cardiothoracic and Vascular Anesthesia 31(3): 1080-1090, 2017