Early extubation after elective surgical aortic valve replacement during the COVID-19 pandemic

Bibliographic Details
Title: Early extubation after elective surgical aortic valve replacement during the COVID-19 pandemic
Authors: Anna Fischbach, Julia Alexandra Simons, Steffen B. Wiegand, Lieselotte Ammon, Rüdger Kopp, Gernot Marx, Rolf Rossaint, Payam Akhyari, Gereon Schälte
Source: Journal of Cardiothoracic Surgery, Vol 19, Iss 1, Pp 1-10 (2024)
Publisher Information: BMC, 2024.
Publication Year: 2024
Collection: LCC:Surgery
LCC:Anesthesiology
Subject Terms: Aortic valve surgery, Surgical aortic valve replacement, Early extubation, Enhanced recovery after cardiac surgery, ERACS, Surgery, RD1-811, Anesthesiology, RD78.3-87.3
More Details: Abstract Background Surgical aortic valve replacement (SAVR) is an established therapy for severe calcific aortic stenosis. Enhanced recovery after cardiac surgery (ERACS) protocols have been shown to improve outcomes for elective cardiac procedures. The COVID-19 pandemic prompted early extubation post-elective surgeries to preserve critical care resources. Aim of this study To investigate the effects of extubating patients within 6 h post-elective SAVR on hospital and ICU length of stay, mortality rates, ICU readmissions, and postoperative pneumonia. Study Design and methods The retrospective analysis at the University Hospital Aachen, Germany, includes data from 2017 to 2022 and compares a total of 73 elective SAVR patients. Among these, 23 patients were extubated within 6 h (EXT group), while 50 patients remained intubated for over 6 h (INT group). Results The INT group experienced longer postoperative ventilation, needed more vasopressor support, had a higher incidence of postoperative pneumonia, and longer ICU length of stay. No significant differences were noted in overall hospital length of stay, mortality, or ICU readmission rates between the groups. Conclusion This study demonstrates that early extubation in high-risk, multimorbid surgical aortic valve replacement patients is safe, and is associated with a reduction of pneumonia rates, and with shorter ICU and hospital length of stays, reinforcing the benefits of ERACS protocols, especially critical during the COVID-19 pandemic to optimize intensive care use.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1749-8090
Relation: https://doaj.org/toc/1749-8090
DOI: 10.1186/s13019-024-02989-0
Access URL: https://doaj.org/article/d4dcd7ded7f344d4ae3aacf5b8cea873
Accession Number: edsdoj.4dcd7ded7f344d4ae3aacf5b8cea873
Database: Directory of Open Access Journals
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More Details
ISSN:17498090
DOI:10.1186/s13019-024-02989-0
Published in:Journal of Cardiothoracic Surgery
Language:English