Schuller J L, Bovill J G, Nijveld A, Patrick M R, Marcelletti C
Br J Anaesth. 1984 Oct;56(10):1101-8. doi: 10.1093/bja/56.10.1101.
The results of early extubation after open heart surgery for congenital heart disease in 209 consecutive patients have been reviewed. No patient younger than 3 months of age, 52% of those between 3 and 12 months, and 88% of those older than 12 months had the tracheal tube removed in the operating theatre. Four patients required reintubation of the trachea, three because of respiratory difficulty and one because of cerebral oedema. There were two deaths in the extubated group. Twelve patients had PaO2 values less than 8.0 kPa after operation, despite adequate oxygen therapy. In four of these, this was related to persistent intracardiac shunting. It is concluded that early extubation after open heart surgery for congenital heart disease has minimal risk in carefully selected patients.
回顾了209例先天性心脏病患者心脏直视手术后早期拔管的结果。年龄小于3个月的患者无一例在手术室拔管，3至12个月的患者中有52%在手术室拔管，12个月以上的患者中有88%在手术室拔管。4例患者需要再次气管插管，3例因呼吸困难，1例因脑水肿。拔管组有2例死亡。12例患者术后尽管进行了充分的氧疗，但动脉血氧分压（PaO2）值仍低于8.0kPa。其中4例与持续的心内分流有关。得出的结论是，在精心挑选的患者中，先天性心脏病心脏直视手术后早期拔管风险极小。
