A Case Report Examining Early Extubation Following Congenital Heart Surgery in a Low Resource Setting

This case report aims to critically analyse the evidence surrounding early extubation in the post-operative phase following complex congenital cardiac surgery. Child A was an 8 year old female who had undergone complex congenital cardiac surgery during an international surgical charity mission. On a...

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Main Author: Catherine Howes
Format: Article
Language:English
Published: Frontiers Media S.A. 2019-03-01
Series:Frontiers in Pediatrics
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fped.2018.00311/full
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author Catherine Howes
author_facet Catherine Howes
author_sort Catherine Howes
collection DOAJ
description This case report aims to critically analyse the evidence surrounding early extubation in the post-operative phase following complex congenital cardiac surgery. Child A was an 8 year old female who had undergone complex congenital cardiac surgery during an international surgical charity mission. On admission to the paediatric intensive care unit Child A appeared to be in good condition and no major complications had occurred intra-operatively. This was considered alongside the situational pressures of resource limitations and the mission's aim to offer surgery to as many children as possible during the available time frame. The decision was made by the team that Child A was a suitable candidate for ‘early extubation.’ Some members of the team were uncomfortable with this approach and felt it could lead to poorer outcomes for patients. Current evidence surrounding early extubation both within international surgical mission trips to low-income and middle-income countries and established cardiac centres within high-income countries is examined and discussed alongside the context of resource limitation. Although the process and implications of early extubation following cardiac surgery needs further research, on the basis of the evidence currently available clinicians could potentially encourage the use of early extubation within clinical practice (for appropriately selected patients) through the utilisation of a multidisciplinary approach, both within the UK and during international surgical charity missions to low-income and middle-income countries.
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spelling doaj.art-2cb2758c7d4047be9a38941e5454b8e12022-12-21T17:33:03ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602019-03-01610.3389/fped.2018.00311409626A Case Report Examining Early Extubation Following Congenital Heart Surgery in a Low Resource SettingCatherine HowesThis case report aims to critically analyse the evidence surrounding early extubation in the post-operative phase following complex congenital cardiac surgery. Child A was an 8 year old female who had undergone complex congenital cardiac surgery during an international surgical charity mission. On admission to the paediatric intensive care unit Child A appeared to be in good condition and no major complications had occurred intra-operatively. This was considered alongside the situational pressures of resource limitations and the mission's aim to offer surgery to as many children as possible during the available time frame. The decision was made by the team that Child A was a suitable candidate for ‘early extubation.’ Some members of the team were uncomfortable with this approach and felt it could lead to poorer outcomes for patients. Current evidence surrounding early extubation both within international surgical mission trips to low-income and middle-income countries and established cardiac centres within high-income countries is examined and discussed alongside the context of resource limitation. Although the process and implications of early extubation following cardiac surgery needs further research, on the basis of the evidence currently available clinicians could potentially encourage the use of early extubation within clinical practice (for appropriately selected patients) through the utilisation of a multidisciplinary approach, both within the UK and during international surgical charity missions to low-income and middle-income countries.https://www.frontiersin.org/article/10.3389/fped.2018.00311/fullearlyextubationfast-tracksurgicalmissioncharity
spellingShingle Catherine Howes
A Case Report Examining Early Extubation Following Congenital Heart Surgery in a Low Resource Setting
Frontiers in Pediatrics
early
extubation
fast-track
surgical
mission
charity
title A Case Report Examining Early Extubation Following Congenital Heart Surgery in a Low Resource Setting
title_full A Case Report Examining Early Extubation Following Congenital Heart Surgery in a Low Resource Setting
title_fullStr A Case Report Examining Early Extubation Following Congenital Heart Surgery in a Low Resource Setting
title_full_unstemmed A Case Report Examining Early Extubation Following Congenital Heart Surgery in a Low Resource Setting
title_short A Case Report Examining Early Extubation Following Congenital Heart Surgery in a Low Resource Setting
title_sort case report examining early extubation following congenital heart surgery in a low resource setting
topic early
extubation
fast-track
surgical
mission
charity
url https://www.frontiersin.org/article/10.3389/fped.2018.00311/full
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