Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-26T05:54:37.376Z Has data issue: false hasContentIssue false
  • English
  • Français

Early extubation in tetralogy of Fallot patients after complete repair

Published online by Cambridge University Press:  08 February 2011

Ranjith Baskar Karthekeyan ,
Ayya Syama Sundar ,
Sajith Sulaiman ,
Periyasamy Thangavelu ,
Mahesh Vakamudi  and
Thenali Kasianandan
Ranjith Baskar Karthekeyan*
Affiliation:
Department of Cardiac Anesthesiology, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, India
Ayya Syama Sundar
Affiliation:
Resident in Cardiac Anesthesia, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, India
Sajith Sulaiman
Affiliation:
Resident in Cardiac Anesthesia, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, India
Periyasamy Thangavelu
Affiliation:
Associate Professor in Cardiac Surgery, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, India
Mahesh Vakamudi
Affiliation:
Professor and Head, Department of Anesthesiology and Critical Care, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, India
Thenali Kasianandan
Affiliation:
Resident in Cardiac Anesthesia, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, India
*
Correspondence to: Associate Professor Ranjith Baskar Karthekeyan, Department of Cardiac Anesthesiology, Sri Ramachandra Medical College and Research Institute, no. 1, Ramachandra Nagar, Porur, Chennai 116, India. Tel: 9144 24986880, 91 9841136568; Fax: 9144 45928627; E-mail: ranjithb73@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim

To document the feasibility of early extubation and to know the effect of age, weight, and post-operative right ventricle/left ventricle ratio in early extubation in intracardiac repair for tetralogy of Fallot.

Materials and methods

This is a prospective study of 76 consecutive patients undergoing intracardiac repair between January, 2010 and April, 2010. The patients were compared between duration of ventilation with age, weight, and post-operative left ventricle/right ventricle ratio.

Results

In the age group less than 10 years, 47 patients were extubated within 4 hours and 12 after 4 hours. In the age group of 10–20 years, eight patients were extubated within 4 hours and seven patients after 4 hours. In the more than 20 years category, one patient was extubated within 4 hours and the other after 4 hours. In the weight category less than 10 kilograms, 17 patients were extubated within 4 hours and seven patients after 4 hours. In the 10–20 kilogram category, 27 patients were extubated before 4 hours and four patients after 4 hours. In the more than 20-kilogram category, 12 patients were extubated before 4 hours and nine patients after 4 hours. Where the ratio was less than 0.5, 47 patients were extubated within 4 hours and 14 patients after 4 hours. Where the ratio was greater than 0.5, nine patients were extubated within 4 hours and six patients after 4 hours.

Conclusion

There was no correlation between duration of ventilation with age, weight, and right ventricle/left ventricle ratio. Early extubation in patients after intracardiac repair in tetralogy of Fallot is safe and effective.

Keywords

Cyanosisfast trackcongenital
Type
Original Articles
Information
Cardiology in the Young , Volume 21 , Issue 4 , 12 July 2011 , pp. 378 - 382
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Kanchi, M. Fast tracking paediatric cardiac surgical patients. Ann Card Anaesth 2005; 8: 33–38.CrossRefGoogle ScholarPubMed
2.Nichols, DG, Cameron, DE, Greeley, WJ. Critical heart disease in infants and children. N Engl J Med 1995; 553–577.Google Scholar
3.Stanger, P, Lucas, RV, Edwards, JE. Anatomic factors causing respiratory distress in acyanotic congenital heart diseases. Pediatrics 1969; 43: 760–769.CrossRefGoogle Scholar
4.Berlinger, NT, Long, C, Foker, J. Tracheobronchial compression in acyanotic congenital heart disease. Ann Otol Rhinol Laryngol 1983; 92: 387–390.CrossRefGoogle ScholarPubMed
5.Christos, A, Qiang, C, Maria, G, et al. Repair of tetralogy of Fallot in infancy with a transvetricular or transatrial approach. Eur J Cardiothorac Surg 2002; 22: 174–183.Google Scholar
6.Fuster, V, Mchoon, DC, Kennedy, MA, et al. Long term evaluation of open heart surgery for tetralogy of Fallot. Am J Cardiol 1980; 40: 635–642.CrossRefGoogle Scholar
7.Hormitz, LN, Vetter, VL, Harken, AH, et al. Electrophysiological characteristics of sustained ventricular tachycardia occurring after surgical repair of tetralogy of Fallot. Am J Cardiol 1980; 46: 446–452.CrossRefGoogle Scholar
8.Papagiannis, S, Rammos, GV, Kirvassilis, GE. Early results after transatrial/transpulmonary repair of tetralogy of Fallot. Eur J Cardiothorac Surg 2002; 22: 582–586.Google Scholar
9.Sunil, KK, Sitaraman, R, Kulbhushan, SD, Parvathi, U. Significant intraoperative right ventricular outflow gradients after repair for tetralogy of Fallot: to revise or not to revise? Ann Thorac Surg 1999; 68: 1705–1713.Google Scholar
10.Halpern, NA. Federal and nationwide intensive care units and health care costs. Crit Care Med 1994; 22: 2001–2007.Google Scholar
11.Barash, PG, Lesovich, F, Katz, JD, et al. Early extubation following pediatric cardiothoracic operation: a viable alternative. Ann Thorac Surg 1980; 29: 228–233.CrossRefGoogle ScholarPubMed
12.Schuller, JL, Bovill, JG, Nijveld, A, et al. Early extubation of the trachea after open heart surgery for congenital heart disease: a review of 3 years experience. Br J Anaesth 1984; 56: 1101–1108.CrossRefGoogle ScholarPubMed
13.Heinle, SJ, Diaz, LK, Fox, LS. Early extubation after cardiac operations in neonates and young infants. J Thorac Cardiovasc Surg 1997; 114: 413–418.CrossRefGoogle ScholarPubMed
14.Shapiro, B, Lichtenthal, P. Inhalational-based anesthetic techniques are the key to early extubation of cardiac surgical patient. J Cardiothorac Vasc Anesth 1993; 7: 135–136.CrossRefGoogle Scholar
15.Quash, A, Loeber, N, Freeley, T, et al. Post respiratory care; A control trial of early and late extubation following coronary artery hypass grafting. Anesthesia 1980; 52: 135–141.Google Scholar
16.Higgans, T. Pro: early extubation is preferable to late extubation in patient following coronary artery surgery. J Cardiothorac Vasc Anesth 1992; 6: 488–493.CrossRefGoogle Scholar
17.Shekerdemain, LS, Penny, DJ, Novick, W. Earlx extubatipn after surgical repair of tetralogy of Fallot. Cardiol Young 2000; 10: 636–637.CrossRefGoogle Scholar