Comparison of ultrafast and fast track extubation after secundum atrial septal defect surgery in pediatric age group

Acta Chir Belg. 2024 Jun;124(3):217-222. doi: 10.1080/00015458.2023.2281097. Epub 2023 Nov 16.

Abstract

Bacground: Patients who underwent ultrafast track on the operating table and fast track extubation in the pediatric intensive care unit for 2 to 6 h after secundum atrial septal defect surgery in the pediatric age group were compared.

Methods: Between January 2013 and February 2017, 60 pediatric patients (24 boys, 36 girls; Mean age 7.5 ± 4.6 years) whose secundum atrial defect was closed were retrospectively analyzed. The patients were separated as those who were extubated on the operating table (Group1,n = 28) and those extubated in the pediatric intensive care unit within 2-6 h postoperatively (Group2,n = 32).

Results: No difference was found in demographic data and preoperative catheter information between the groups. Cardiopulmonary bypass time was 20(18-25)/27.5(20-30)minutes (p:0.001), the cross-clamp time was 10(10-15)/15(11-20)minutes(p:0.004), the postoperative drainage amount was 50(25-50)/60(32.5-100)ml(p:0.013), the length of stay in the intensive care unit was 1(1--1)/1(1-2)day(p:0.025), the length of stay after intensive care was 3(2-3)/3(3-4)days(p:0.001) and the total hospital stay was 4(3-4)/5(4-5.5) days (p < 0.001), which were respectively shorter for the group 1 compared to 2. Postoperative blood product replacement, positive inotrope support, pericardial effusion, mortality, and morbidity were not detected in either groups.

Conclusion: In this study, it was observed that the UFT extubation was safe for the patients who were operated for secundum ASD, in the pediatric age group, and had a cross-clamp time not exceeding 15 min. It was found that the amount of drainage, length of stay in the intensive care unit, post-intensive care unit, and the total hospital stay of patients extubated on the operating table were shorter.

Keywords: Ultrafast; atrial septal defect; extubation; fast track; pediatric.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Airway Extubation*
  • Cardiac Surgical Procedures / methods
  • Cardiopulmonary Bypass
  • Child
  • Child, Preschool
  • Female
  • Heart Septal Defects, Atrial* / surgery
  • Humans
  • Intensive Care Units, Pediatric*
  • Length of Stay* / statistics & numerical data
  • Male
  • Operative Time
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome