초록접수 현황
| 20F-050 | 구연 발표 |
Operating room extubation following minimally invasive cardiac surgery for better postoperative recovery: 800 consecutive cases of single center experience
Chee-hoon Lee, MD, Min Ho Ju, MD, Ji Hye Lee RN, Hyung Gon Je, MD, PhD
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Medical Research Institute of Pusan National University
Purpose : Operating room (OR) extubation after minimally invasive cardiac surgery (MICS) may facilitate the patients’ postoperative recovery. The study aims to evaluate the feasibility of the strategy through our 800 cases of experience.
Methods : From March 2009 to June 2020, 800 consecutive patients (mean age 53.8 ± 15.4 years, 437 females) those who underwent OR extubation after MICS were enrolled. MICS was conducted through 777 (97.1%) cases of mini-thoracotomy and 23 (2.9%) cases of partial sternotomy. 679 (84.9%) cases were isolated operations and the rest were combined operations. 31 (3.9%) patients had a history of prior cardiac surgery.
Results : During the study period, the proportion of OR extubation after MICS among all cardiac surgeries gradually increased to 49.8% (Figure). Mean EuroSCORE II was 2.3 ± 3.7. There were 2 (0.2%) early deaths, 14 (1.8%) re-explorations for bleeding, 2 (0.2%) permanent neurologic injuries, 2 (0.2%) acute renal injuries requiring hemodialysis and 1 (0.1%) low cardiac output syndrome requiring mechanical circulatory support. Mean cardiopulmonary bypass and cardiac ischemic times were 90.2 ± 39.1 and 62.3 ± 29.1 minutes, respectively. In 639 (79.9%) patients, transfusion was unnecessary. Median intensive care unit and postoperative hospital stay were 24 hours [IQR, 22 – 26] and 5 days [IQR, 4 – 6], respectively. Re-intubation during hospitalization was required in 10 (1.2%) patients.
Conclusion : The strategy of OR extubation combined with MICS showed acceptable safety. It can be a reasonable alternative strategy for well selected patients to enhance postoperative recovery.
Methods : From March 2009 to June 2020, 800 consecutive patients (mean age 53.8 ± 15.4 years, 437 females) those who underwent OR extubation after MICS were enrolled. MICS was conducted through 777 (97.1%) cases of mini-thoracotomy and 23 (2.9%) cases of partial sternotomy. 679 (84.9%) cases were isolated operations and the rest were combined operations. 31 (3.9%) patients had a history of prior cardiac surgery.
Results : During the study period, the proportion of OR extubation after MICS among all cardiac surgeries gradually increased to 49.8% (Figure). Mean EuroSCORE II was 2.3 ± 3.7. There were 2 (0.2%) early deaths, 14 (1.8%) re-explorations for bleeding, 2 (0.2%) permanent neurologic injuries, 2 (0.2%) acute renal injuries requiring hemodialysis and 1 (0.1%) low cardiac output syndrome requiring mechanical circulatory support. Mean cardiopulmonary bypass and cardiac ischemic times were 90.2 ± 39.1 and 62.3 ± 29.1 minutes, respectively. In 639 (79.9%) patients, transfusion was unnecessary. Median intensive care unit and postoperative hospital stay were 24 hours [IQR, 22 – 26] and 5 days [IQR, 4 – 6], respectively. Re-intubation during hospitalization was required in 10 (1.2%) patients.
Conclusion : The strategy of OR extubation combined with MICS showed acceptable safety. It can be a reasonable alternative strategy for well selected patients to enhance postoperative recovery.
책임저자: Hyung Gon Je
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Medical Research Institute of Pusan National University
발표자: Chee-hoon Lee, E-mail : liebemh@gmail.com