Cardiothoracic & vascular anesthesia
On‐Table Extubation After Pediatric Cardiac Surgery: A Systematic Review
Authors' conclusion
Although this systematic review suggests that on-table extubation may be associated with potentially better outcomes following pediatric cardiac surgery, no safe conclusions can be drawn about its benefit due to the high heterogeneity and potential high risk of bias of most included studies.
Study context
- Population
- Pediatric patients (< 18 years) undergoing cardiovascular surgery29 studies (2 randomized controlled trials (RCTs), 27 observational)
- Participants
- 9,070 patients
- Comparison
- On-table vs off-table extubation
- Outcome
- Reintubation rate, mortality, ICU and hospital LOS
Methodological detailsRisk of bias elevated among observational studies; high heterogeneity limited meta-analysis feasibility
- Risk of bias elevated among observational studies; high heterogeneity limited meta-analysis feasibility
Pooled result
As reported in the abstract
- Lower reintubation rates with on-table extubation in most studies, not consistent across all
- Mortality generally comparable between groups
- Intensive care unit (ICU) and hospital length of stay (LOS) consistently shorter in the on-table group
Further pooled results
Postoperative arterial pH, lactate and PaCO2
- Better arterial pH, lactate and PaCO2 profile in the on-table group
Original publication
On‐Table Extubation After Pediatric Cardiac Surgery: A Systematic Review. Paediatr Anaesth. Published 13 August 2025. doi:10.
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