Clinical Outcomes and Cost of Ventilator Weaning and Endotracheal Extubation Guided by An Established Ventilator Weaning Protocol in Patients Undergoing Elective Cardiac Surgery

Objective: To compare successful early extubation rates, complications, and cost before and after the use of an established ventilator weaning protocol in patients undergoing elective cardiac surgery. Materials and Methods: Subjects were adult patients undergoing elective cardiac surgery who were c...

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Autores principales:	Supanan Innok, Witchuda Dokphueng, Kamol Udol, Worawong Slisatkorn, Prasert Sawasdiwipachai
Formato:	article
Lenguaje:	EN
Publicado:	Mahidol University 2021
Materias:	Early extubation cardiac surgery ventilator weaning protocol complication cost Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/06240049806c4b7dbf2fdd47c7a446c4
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spelling	oai:doaj.org-article:06240049806c4b7dbf2fdd47c7a446c42021-12-01T10:07:37ZClinical Outcomes and Cost of Ventilator Weaning and Endotracheal Extubation Guided by An Established Ventilator Weaning Protocol in Patients Undergoing Elective Cardiac Surgery10.33192/Smj.2021.1062228-8082https://doaj.org/article/06240049806c4b7dbf2fdd47c7a446c42021-12-01T00:00:00Zhttps://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/255150https://doaj.org/toc/2228-8082 Objective: To compare successful early extubation rates, complications, and cost before and after the use of an established ventilator weaning protocol in patients undergoing elective cardiac surgery. Materials and Methods: Subjects were adult patients undergoing elective cardiac surgery who were clinically stable within 2 hours after surgery. The control group underwent conventional ventilator weaning at the discretion of their attending staff. The intervention group underwent protocol-guided ventilator weaning. The primary outcome was a successful early extubation (within 6 hours after surgery). Secondary outcomes were complications from weaning to 24 hours after surgery, and the relevant cost related to respiratory and cardiovascular care within 24 hours after admission to the postoperative intensive care unit. Results: The primary outcome occurred in 37 out of 65 patients (56.9%) in the intervention group and in 5 out of 65 patients (7.7%) in the control group (adjusted odds ratio 20.6; 95% confidence interval 6.7–62.9, p<0.001). The complication rates were not statistically different between the intervention and control groups (26.2% vs. 20.0%, p=0.41). The relevant cost, approximated by the service charges, related to respiratory and cardiovascular care was significantly less in the intervention group than in the control group (median 2,491 vs. 2,711 Thai baht, p<0.001). Conclusion: The use of the established ventilator weaning protocol after elective cardiac surgery was associated with a higher rate of successful early extubation and lower cost related to respiratory and cardiovascular care compared to the conventional practices of ventilator weaning and extubation. The rates of overall complications were not significantly different. Supanan InnokWitchuda DokphuengKamol UdolWorawong SlisatkornPrasert SawasdiwipachaiMahidol UniversityarticleEarly extubationcardiac surgeryventilator weaning protocolcomplicationcostMedicine (General)R5-920ENSiriraj Medical Journal, Vol 73, Iss 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Early extubation cardiac surgery ventilator weaning protocol complication cost Medicine (General) R5-920
spellingShingle	Early extubation cardiac surgery ventilator weaning protocol complication cost Medicine (General) R5-920 Supanan Innok Witchuda Dokphueng Kamol Udol Worawong Slisatkorn Prasert Sawasdiwipachai Clinical Outcomes and Cost of Ventilator Weaning and Endotracheal Extubation Guided by An Established Ventilator Weaning Protocol in Patients Undergoing Elective Cardiac Surgery
description	Objective: To compare successful early extubation rates, complications, and cost before and after the use of an established ventilator weaning protocol in patients undergoing elective cardiac surgery. Materials and Methods: Subjects were adult patients undergoing elective cardiac surgery who were clinically stable within 2 hours after surgery. The control group underwent conventional ventilator weaning at the discretion of their attending staff. The intervention group underwent protocol-guided ventilator weaning. The primary outcome was a successful early extubation (within 6 hours after surgery). Secondary outcomes were complications from weaning to 24 hours after surgery, and the relevant cost related to respiratory and cardiovascular care within 24 hours after admission to the postoperative intensive care unit. Results: The primary outcome occurred in 37 out of 65 patients (56.9%) in the intervention group and in 5 out of 65 patients (7.7%) in the control group (adjusted odds ratio 20.6; 95% confidence interval 6.7–62.9, p<0.001). The complication rates were not statistically different between the intervention and control groups (26.2% vs. 20.0%, p=0.41). The relevant cost, approximated by the service charges, related to respiratory and cardiovascular care was significantly less in the intervention group than in the control group (median 2,491 vs. 2,711 Thai baht, p<0.001). Conclusion: The use of the established ventilator weaning protocol after elective cardiac surgery was associated with a higher rate of successful early extubation and lower cost related to respiratory and cardiovascular care compared to the conventional practices of ventilator weaning and extubation. The rates of overall complications were not significantly different.
format	article
author	Supanan Innok Witchuda Dokphueng Kamol Udol Worawong Slisatkorn Prasert Sawasdiwipachai
author_facet	Supanan Innok Witchuda Dokphueng Kamol Udol Worawong Slisatkorn Prasert Sawasdiwipachai
author_sort	Supanan Innok
title	Clinical Outcomes and Cost of Ventilator Weaning and Endotracheal Extubation Guided by An Established Ventilator Weaning Protocol in Patients Undergoing Elective Cardiac Surgery
title_short	Clinical Outcomes and Cost of Ventilator Weaning and Endotracheal Extubation Guided by An Established Ventilator Weaning Protocol in Patients Undergoing Elective Cardiac Surgery
title_full	Clinical Outcomes and Cost of Ventilator Weaning and Endotracheal Extubation Guided by An Established Ventilator Weaning Protocol in Patients Undergoing Elective Cardiac Surgery
title_fullStr	Clinical Outcomes and Cost of Ventilator Weaning and Endotracheal Extubation Guided by An Established Ventilator Weaning Protocol in Patients Undergoing Elective Cardiac Surgery
title_full_unstemmed	Clinical Outcomes and Cost of Ventilator Weaning and Endotracheal Extubation Guided by An Established Ventilator Weaning Protocol in Patients Undergoing Elective Cardiac Surgery
title_sort	clinical outcomes and cost of ventilator weaning and endotracheal extubation guided by an established ventilator weaning protocol in patients undergoing elective cardiac surgery
publisher	Mahidol University
publishDate	2021
url	https://doaj.org/article/06240049806c4b7dbf2fdd47c7a446c4
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Clinical Outcomes and Cost of Ventilator Weaning and Endotracheal Extubation Guided by An Established Ventilator Weaning Protocol in Patients Undergoing Elective Cardiac Surgery

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