Rick Factors associated with Immediate Orotracheal Extubation Failure in Surgical Procedures
Keywords:
risk factor; ultra-fastrack; cardiac surgeryAbstract
Introduction: Short periods of postoperative orotracheal intubation in cardiac surgery are associated with a lower incidence of perioperative complications, but several risk factors are described that may be associated with achieving this goal. Objective: To determine the risk factors associated with failure to implement the immediate extubation protocol.
Methods: A retrospective observational cohort study was conducted with patients scheduled for elective cardiac surgery from January 2015 to January 2022. The sample was non-probability and divided into two groups: Group I (immediate extubation) and Group II (failure to immediately extubate). Dependent variables (failure to immediately extubate), independent variables (preoperative and intraoperative risk factors), and a confounding variable (fentanyl dose) were analyzed.
Results: A sample of 65 patients was included, Group I n = 5, and Group II n = 60. It was determined that the value of glomerular filtration, surgical time (p = 0.03), aortic cross-clamping time and extracorporeal circulation time (GI = 92.2 ± 20.4; GII = 120.6 ± 43.7, p = 0.05) were the factors that most influenced the non-implementation of immediate extubation.
Conclusions: Studies with a higher level of evidence are needed to safely validate all the risk factors that constitute an obstacle to achieving orotracheal extubation during the first hour postoperatively, which will allow us to implement this technique, even in these patients, or exclude them from the protocol early.
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