Early extubation after surgical repair of tetralogy of Fallot

In recent years, post-operative intensive care of the child with congenital cardiac disease has placed an emphasis on earlier weaning from mechanical ventilation. We describe our experience of postoperative fast-tracking of c hildren undergoing cardiac surgery during a charitable mission in Venezuela , where resources and equipment were severely limited. During our stay, 11 children, with a median age of 2 years, underwent total correction of tetra logy of Fallot. The median duration of ventilation was 2.5 hours, and all p atients were extubated within 12 hours of surgery. Effective analgesia was achieved without the need for continuous intravenous infusions of opiates. This experience shows that early extubation can safely be carried out in we ll-selected patients after surgery to correct congenital cardiac malformati ons. This allows faster throughput of patients, and helps provide an effici ent and cost-effective service.