Barash P G, Lescovich F, Katz J D, Talner N S, Stansel H C
Ann Thorac Surg. 1980 Mar;29(3):228-33. doi: 10.1016/s0003-4975(10)61872-3.
A protocol is presented that facilitates early extubation following pediatric cardiothoracic operations. A total of 197 consecutive patients were managed according to this protocol. Fifty percent of the patients were less than 3 years old. Cardiopulmonary bypass was required in 113 (57%) of the surgical procedures. Extubation immediately following the surgical procedure was accomplished in 142 (72%) of the patients. Pulmonary complications occurred in 8 of these 142 patients (6%) and in 10 (18%) of the 55 patients requiring postoperative mechanical ventilation. Of the patients having early extubation, 5 (4%) required reintubation. One death in this group was unrelated to pulmonary function. There were 16 deaths among the 55 patients managed with mechanical ventilation. Carefully conducted early extubation provided specific advantages over routine postoperative mechanical ventilation. Modern techniques of anesthesia and surgical repair of congenital heart disease can decrease the requirement for postoperative mechanical ventilation and the potential for related complications.
本文介绍了一种有助于小儿心胸手术后早期拔管的方案。共有197例连续患者按照该方案进行管理。50%的患者年龄小于3岁。113例（57%）手术需要体外循环。142例（72%）患者在手术后立即完成拔管。这142例患者中有8例（6%）发生肺部并发症，55例需要术后机械通气的患者中有10例（18%）发生肺部并发症。在早期拔管的患者中，5例（4%）需要重新插管。该组中有1例死亡与肺功能无关。在接受机械通气的55例患者中有16例死亡。与常规术后机械通气相比，精心实施的早期拔管具有特定优势。现代麻醉技术和先天性心脏病手术修复方法可减少术后机械通气需求及相关并发症的可能性。
