Early Extubation in Infancy and Early Childhood Following Heart Surgery: outcome analysis and predictors of failure

Abstract

Early extubation (EE) has become a critical quality determinant in perioperative management for children undergoing congenital heart surgery (CHS) during early childhood. We sought to determine the benefits of EE, total hospital costs, and identify predictors of failure following EE. A retrospective chart review of children ?6 years old who underwent CHS at the Children's Hospital of Georgia between January-December 2017 was performed. EE was defined as successful removal of the endotracheal tube in the operating room or upon arrival in intensive care unit (ICU). Patients were categorized based on single-ventricle (Group A) and biventricular (Group-B) anatomy. Perioperative data points were compared and multivariate analysis was used to identify the predictors of EE failure and total hospital cost. We found that children who were EE spend significantly less overall time in both the ICU and hospital. Furthermore, we found that children who were EE had a significant reduction in total hospital cost than patients who were not EE. Based on our analysis, we concluded that EE is safe and feasible in reducing hospital costs for children undergoing congenital heart surgery.