Cardiothoracic & vascular anesthesia
Evaluation of the Effects of an Extubation Protocol With Neostigmine on Duration of Mechanical Ventilation After Cardiac Surgery
Main finding · Postoperative duration of mechanical ventilationResult — go to the resultIncidence rate ratio 0.82 95% CI 0.72–0.94Authors' conclusion
The application of an extubation protocol incorporating NMBR based on neuromuscular monitoring was associated with a decrease in postoperative duration of mechanical ventilation and facilitated more patients meeting the early extubation benchmark without an increased risk of respiratory complications or adverse outcomes.
Study context
- Population
- Cardiac surgery patients at a university hospital, February 2, 2015, to March 31, 2017
- Participants
- 1,843 patients
- Exposure
- Extubation protocol with NMB reversal guided by TOF monitoring (postprotocol) vs preprotocol
- Outcome
- Postoperative duration of mechanical ventilation
Methodological detailsinterrupted time series, single-centre
- Interrupted time series
- Single-centre
Main finding
As reported in the abstract
Incidence rate ratio
0.82
95% CI 0.72–0.94
P < 0.01
Observational data: associations, not effects.
Secondary outcomes
Patients extubated ≤6 hours
| OR (95% CI) | P value | ||
|---|---|---|---|
| Extubation protocolStatistically insignificant 26% increase | 1.26 (0.97–1.65) | P = 0.09 | |
| 0.512Odds ratio (log scale) |
ICU length of stay (LOS)
| IRR (95% CI) | P value | ||
|---|---|---|---|
| Extubation protocol13% shorter | 0.87 (0.79–0.97) | P < 0.01 | |
| 0.512Incidence rate ratio (log scale) |
| Outcome | IRR | P value |
|---|---|---|
| Extubation times, isolated CABG (subgroup) | 0.82 | P < 0.01 |
Safety
Pulmonary complications and adverse outcomes
- Differences between pre- and postprotocol groups clinically insignificant
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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