Very early extubation in children after cardiac surgery*

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Abstract
Very early extubation of children after cardiac surgery has been suggested as a safe alternative to prolonged postoperative intubation but is still not common practice. Studies of early extubation in children may not have described reasons for failure to extubate, or have included nonbypass or only low-risk repairs. We present our experience with very early extubation in an inclusive group of children after cardiac surgery. Retrospective chart review. University hospital operating room and pediatric intensive care unit (ICU). A total of 102 consecutive children (age Forty-eight patients were extubated early (88% in the operating room, 12% on arrival in ICU). Patients extubated late were younger (13.8 ± 26.2 vs. 47.6 ± 44.5 months), smaller (8.1 ± 10.7 vs.17.5 ± 14.2 kg), and had higher ASA scores than patients extubated early (p 2 Successful early extubation of even young children is possible and easily accomplished in most children undergoing cardiopulmonary bypass, even with complex procedures, but advantages of extubation in the operating room vs. immediate ICU extubation remain unclear. Transient mild-to-moderate mixed acidosis is common and requires no treatment. Full implementation requires acceptance by surgical and ICU staffs.