EARLY EXTUBATION AFTER CARDIAC OPERATIONS IN NEONATES AND YOUNG INFANTS

Objective: This study was undertaken to determine the feasibility of e arly extubation of the neonate and young infant after surgical repair of congenital heart lesions, Methods: The records of all patients less than 90 days of age who had cardiac operations over a 1-year period w ere reviewed, During this time, all patients were managed as potential candidates for early extubation, Fifty-six patients are included with a mean age of 32 +/- 31 days and a mean weight of 3.7 +/- 0.9 kg, Res ults: Twenty-eight patients (50%) were extubated in the operating room or within 3 hours after arriving in the intensive care unit, This inc luded 38% of patients less than 7 days of age, 50% of patients 8 to 30 days of age, 44% of patients 31 to 60 days of age, and 69% of patient s 61 to 90 days of age, Three patients (11%) extubated early required reintubation. No deaths were related to early extubation, Only one pat ient was negatively affected by early extubation, Patients extubated e arly had shorter stays in the intensive care unit (3.3 +/- 3.9 vs 6.7 +/- 2.9 days) and shorter postoperative hospital stays (5.9 +/- 3.3 vs 13.5 +/- 9.7 days), as well as lower intensive care unit ($5,851 +/- $7,225 vs $12,064 +/- $4,419) and total hospital ($21,108 +/- $14,941 vs $31,608 +/- $9,861) costs than patients who were ventilated, Conclu sions: Early extubation can be accomplished safely in many neonates an d young infants undergoing cardiac operations for repair of congenital heart defects and can shorten hospital stay and reduce costs.