Strategies for Early Liberation from Mechanical Ventilation in the Intensive Care Unit After Coronary Artery Bypass Grafting: A Scoping Review

Early liberation from mechanical ventilation is an important component of postoperative care after coronary artery bypass grafting (CABG), but the strategies, extubation-readiness criteria, and reported outcomes remain heterogeneous. This scoping review mapped early ventilator liberation strategies, clinical extubation criteria, and relevant outcomes in adults undergoing CABG. Following Joanna Briggs Institute methodology and PRISMA-ScR, PubMed/MEDLINE, Web of Science, Cochrane CENTRAL, ScienceDirect, and SciELO were searched from inception to 31 December 2025. Evidence was synthesized descriptively. Of 2374 records identified, 19 studies published between 1977 and 2025 were included. Eleven evaluated automated weaning, five clinical early-extubation protocols, one a non-automated ventilatory strategy, and two observational assessments. Central values for time to extubation ranged from 1.8 to 18.2 h. Eight studies reported a statistically significant reduction in time to extubation, seven found no significant difference, and the comparison was not evaluable in four. Readiness criteria included hemodynamic, gas-exchange, neurological, spontaneous-breathing, and bleeding-control domains, whereas safety outcomes were inconsistently reported. The evidence was heterogeneous and did not establish the superiority of any strategy. Standardized readiness criteria, uniform time definitions, and consistent reporting of clinical and safety outcomes are needed to improve comparability and applicability.