Pediatric anesthesia & critical care
Incidence, Risk Factors, and Outcomes of Non‐Extubation in the Operating Room Following Elective Pediatric Neurosurgery—A Prospective Observational Study
Authors' conclusion
A significant proportion of children are not extubated immediately after elective pediatric neurosurgery. Higher ASA grade, lower cranial nerve palsy, prolonged surgery, intraoperative complications, and higher blood transfusion increase the risk of delayed extubation. Non-extubation in the OR is associated with poor postoperative outcomes of neurological decline, in-hospital mortality, and longer duration of hospital stay.
Study context
- Population
- Children aged <18 years undergoing elective neurosurgery under GA at a university hospital, February 2022 to November 2023
- Participants
- 738 children
- Outcome
- Incidence of non-extubation in the OR (retention of the tracheal tube before leaving the OR)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Incidence of non-extubation in the OR
Incidence of non-extubation
13.01%
96/738
Observational data: associations, not effects.
Further findings
Predictors of non-extubation
| OR (95% CI) | P value | ||
|---|---|---|---|
| Higher ASA grade | 2.86 (1.78–4.69) | P < 0.001 | |
| Preoperative lower cranial nerve palsy | 2.35 (1.23–4.43) | P = 0.010 | |
| Prolonged surgery | 1.45 (1.26–1.68) | P < 0.001 | |
| Intraoperative complications | 4.89 (2.69–8.89) | P < 0.001 | |
| Higher intraoperative blood transfusion rates | 2.46 (1.37–4.5) | P = 0.002 | |
| 0.10.31310Odds ratio (log scale) |
Postoperative outcomes
- Non-extubation in the OR associated with postoperative neurological deterioration, higher in-hospital mortality, and prolonged intensive care unit (ICU) and hospital stay
Original publication
Incidence, Risk Factors, and Outcomes of Non‐Extubation in the Operating Room Following Elective Pediatric Neurosurgery—A Prospective Observational Study. Paediatr Anaesth. Published 17 March 2025. doi:10.
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