Commentary: How we enter the chest in cardiac surgery—Does it really matter for the purpose of early extubation?

Rapid weaning from anesthesia and extubation in the operative room after cardiac surgery is living a new renaissance. Times have greatly changed since its first introduction,1 and the current relentless search for quality metrics or the widespread popularity of enhanced recovery after cardiac surgery protocols2 may present newer incentives. Inherent reluctance is still encountered, however, particularly among intensive care providers. The perception is to receive a patient possibly prone to respiratory complications who now will have to be rapidly addressed in the intensive care unit,3 or the suggested lack of clinical advantage in terms of early extubation, unless the timing exceeds 12 hours.