Key result
Early tracheal extubation significantly reduced intensive care unit length of stay by a mean of 9.90 hours compared to conventional extubation in patients undergoing cardiac surgery.
Why the study?
Promoting rapid recovery and quality of life after cardiac surgery is a focus of attention, prompting a comparison of the safety and efficacy of early versus conventional extubation.
Does early tracheal extubation reduce ICU and hospital length of stay and postoperative complications in adult patients undergoing cardiac surgery?
Meta-Analysis (n=1,554)
Does early tracheal extubation reduce ICU and hospital length of stay and postoperative complications in adult patients undergoing cardiac surgery?
Mean Difference: -9.9 (95% CI -15.69–-4.51)
p-value: p=<0.01
Early tracheal extubation after cardiac surgery effectively reduces ICU and hospital length of stay as well as myocardial infarction risk, but clinicians must be vigilant regarding an increased risk of re-intubation.
Supports early extubation protocols post-cardiac surgery to reduce ICU stay; confirms RCT meta-analysis benefits with re-intubation caution.
Background: How to promote the rapid recovery of patients undergoing cardiac surgery and quality of life has been the focus of doctors’ attention. To compare the safety and efficacy of early cardiac extubation with conventional extubation (late extubation) in patients undergoing cardiac surgery. Methods: Ovid MEDLINE, Ovid Embase, EBSCOhost, Cochrane Library and ISIWeb of Science (1946–November 25, 2019) were searched to obtain randomized controlled trials of early tracheal extubation in patients undergoing cardiac surgery. Results: Compared with the conventional care group, in terms of effectiveness, the intensive care unit (ICU) stay and hospital length of stay in the early tracheal extubation was significantly shorter. In terms of security, most outcomes, including mortality, bleeding, stroke, acute renal failure and arrhythmia, were not statistically significant, except for myocardial infarction. However, the risk of re-intubation in the early tracheal extubation was higher than that of conventional extubation. Conclusions: This meta-analysis confirmed that early tracheal extubation may effectively reduce ICU hospitalization time, hospital length of stay and the risk of myocardial infarction. Although early tracheal extubation does not increase the risk of safety events, the clinicians need to pay more attention to be aware of possible risk of re-intubation. Meanwhile, as a key time point for extubation within 4 hours, it may help a little to reduce the risk of re-intubation and myocardial infarction.
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Zhao et al. (2020) conducted a meta-analysis in Cardiac surgery (n=1,554). Early tracheal extubation vs. Conventional extubation was evaluated on ICU length of stay (MD -9.90, 95% CI -15.69, -4.51, p=<0.01). Early tracheal extubation significantly reduced intensive care unit length of stay by a mean of 9.90 hours compared to conventional extubation in patients undergoing cardiac surgery.
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