pediatric Intensivist(AP) Peshawar Institute Of Cardiology(PIC) peshawar, Pakistan
Abstract:
Objective: To evaluate the efficacy of Early Extubation (EE) in children after cardiac surgery from a public sector hospital in a developing country. Study
Design: Description Cross Sectional Study Setting and Duration of Study: The study was conducted at Peshawar Institute of Cardiology. Peshawar Institute of Cardiology is a newly established cardiovascular Institute which has fellowship-trained paediatric cardiologists, paediatric intensivists, and paediatric cardiac surgeons. The total duration of study was 3 months that is from 01/06/2021 till 26/08/2021. Patient and Methodology: By using OpenEpi, an online sample size calculator, a sample size of 60 was estimated. After applying eligibility criteria, 58 patients were enrolled , followed and their data was collected and reported. All these patients underwent early extubation .Early extubation is defined as patient extubated within 6 hours of admission. The data collector collected information regarding patient’s preoperative cardiac diagnosis, procedure, postoperative course including the length of stay (LOS) in Intensive Care Unit (ICU), duration of invasive and non-invasive ventilation, failure of extubation, hemodynamic data, postoperative complications, and mortality.. The non-probability purposive sampling technique was used for enrolling patients. Data were entered and analysed in SPSS version 21. The descriptive data is reported in terms of frequency and proportions. For the continuous data, mean with standard deviation (SD) were reported. Ethical Review Committee permission was taken before initiation of the study.
Results: A total of 60 children were admitted after cardiac surgery in paediatric cardiac intensive care unit over a duration of three months. The median duration of Congenital ICU stay was one day among survivors. 7 patients (12%) were < 1 year old , 8 patients (13%) were between 1-5 years old, Thirty-seven patients (63%) were between 5-15 years old, , 6 patients (10%) were > 15 years old and. About 23 patients (40%) were male. Surgeries performed were AR/MVR (13), VSD closure (6), ASD closure (4), PDA ligation (4) ,PAPVR (2), TOF (17) , PA banding (1) and others (11) .One got reintubated and two patients expired after few days in Congenital ICU.
Conclusion: Most of children after cardiac surgery even infants can be successfully extubated in LIMCs.
