Our Summary

This research paper discusses the growing popularity of a procedure called “on-table extubation” following pediatric cardiac surgery. This procedure involves removing a patient’s breathing tube right on the operating table after surgery instead of waiting until they are in the recovery room. The authors share their experiences with using this method on children after heart surgery in developing countries and support their observations with existing scientific literature.

FAQs

  1. What is on-table extubation in the context of pediatric cardiac surgery?
  2. Has there been an increasing trend in the practice of on-table extubation post pediatric cardiac surgery worldwide?
  3. What has been the experience with on-table extubation in the developing world?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pediatric cardiac surgery is to follow all post-operative care instructions carefully, including monitoring for signs of infection, keeping the surgical site clean, and attending all follow-up appointments with the medical team. It is important to closely follow the doctor’s recommendations to ensure the best possible outcome for the child’s recovery.

Suitable For

Patients who are typically recommended for pediatric cardiac surgery include those with congenital heart defects, acquired heart disease, and other cardiovascular conditions that require surgical intervention. These patients may range in age from newborns to adolescents. The decision to recommend pediatric cardiac surgery is based on the specific diagnosis, severity of the condition, and the potential benefits of surgical intervention for the patient’s overall health and well-being. It is important for patients and their families to consult with a pediatric cardiologist and cardiac surgeon to determine the best course of treatment for their individual situation.

Timeline

Before pediatric cardiac surgery:

  • Consultation with a pediatric cardiologist to diagnose the heart condition and determine the need for surgery
  • Pre-operative evaluation and testing to assess the child’s overall health and readiness for surgery
  • Admission to the hospital for the surgery, with pre-operative fasting and preparation
  • Anesthesia induction and intubation before the surgery begins

After pediatric cardiac surgery:

  • Recovery in the intensive care unit (ICU) with close monitoring of vital signs and oxygen levels
  • Gradual weaning off of mechanical ventilation and extubation once the child is stable
  • Pain management and medication to prevent infection and control inflammation
  • Physical therapy and rehabilitation to help the child regain strength and mobility
  • Follow-up appointments with the cardiologist to monitor the child’s progress and adjust treatment as needed.

What to Ask Your Doctor

  1. What are the risks and benefits of on-table extubation after pediatric cardiac surgery?
  2. How does on-table extubation impact the recovery process for children undergoing cardiac surgery?
  3. How does on-table extubation affect the length of stay in the intensive care unit and overall hospital stay?
  4. Are there specific criteria that need to be met in order for a child to be considered for on-table extubation after cardiac surgery?
  5. What is the success rate of on-table extubation in children undergoing cardiac surgery in your practice?
  6. Are there any potential complications or adverse effects associated with on-table extubation that I should be aware of?
  7. How will pain management be addressed if my child is extubated on-table after cardiac surgery?
  8. What is the follow-up care plan for a child who undergoes on-table extubation after cardiac surgery?
  9. How will the medical team monitor and support my child’s respiratory function after on-table extubation?
  10. Are there any alternative options to on-table extubation that should be considered for my child’s specific case?

Reference

Authors: Garg RK, Thareen JK, Mehmood A, Nakao M, Basappanavar V, Jain R, Sam M, Khan AA, Di Donato RM. Journal: J Cardiothorac Vasc Anesth. 2020 Oct;34(10):2611-2617. doi: 10.1053/j.jvca.2019.11.032. Epub 2019 Nov 23. PMID: 32057669