Durai Samy Nandha Kumar, Taksande Karuna
Anesthesiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Jul 10;16(7):e64216. doi: 10.7759/cureus.64216. eCollection 2024 Jul.
Pediatric cardiac surgery poses significant challenges in developing countries, where a considerable number of children require intervention for congenital heart disease (CHD). The utilization of endotracheal intubation and anesthesia is pivotal in conducting surgical or angiography procedures on patients with CHD exhibiting diverse anatomical and hemodynamic characteristics. The decision to extubate pediatric patients following cardiac surgery remains a crucial element of postoperative care. This article explores the complexities surrounding extubation decision-making in this population, emphasizing the critical role of surgical, physiological, and postoperative factors. Various preoperative and intraoperative factors influence the timing of extubation. Early extubation is increasingly prevalent, offering benefits like reduced length of stay and minimized drug exposure. Multidisciplinary collaboration and protocol-driven strategies contribute to improved extubation outcomes, emphasizing the need for a comprehensive approach in pediatric cardiac surgery. Future research can focus on the implementation and efficacy of standardized extubation procedures involving collaboration among healthcare experts.
在发展中国家，小儿心脏手术面临重大挑战，因为有相当数量的儿童需要接受先天性心脏病（CHD）干预治疗。对于患有表现出不同解剖和血流动力学特征的CHD患者，气管插管和麻醉的使用对于进行外科手术或血管造影程序至关重要。小儿心脏手术后拔管的决定仍然是术后护理的关键要素。本文探讨了该人群拔管决策的复杂性，强调了手术、生理和术后因素的关键作用。各种术前和术中因素会影响拔管时间。早期拔管越来越普遍，具有缩短住院时间和减少药物暴露等益处。多学科协作和基于方案的策略有助于改善拔管结果，强调了小儿心脏手术采用综合方法的必要性。未来的研究可以聚焦于涉及医疗保健专家协作的标准化拔管程序的实施和效果。
