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J Thorac Cardiovasc Surg 1997;114:687
© 1997 Mosby, Inc.

LETTERS TO THE EDITOR

Early tracheal extubation after coronary artery bypass grafting

Professor of Surgery
University of Ceará

Leny Monte

Anesthesiology
Casa de Saúde São Raimundo
Ceará Brazil

To the Editor:

We read with great interest the report by Cheng and colleagues ¹ about early versus conventional tracheal extubation after coronary artery bypass grafting. This subject is of great importance in areas in which resources are limited.

In July 1976 we ² published our first article on early extubation in general cardiac surgery. In support of early extubation after valve replacement, Midell and associates ³ in 1974 published their experience with 100 cases, and Barash and coworkers ⁴ of Yale University, in 1980, showed that only 4% of patients undergoing pediatric cardiac operations required reintubation. In August of 1980, in a thesis to become professor of surgery at the University of Ceará Medical School, Jucá ⁵ reported the results in 105 patients undergoing coronary bypass grafting who were subjected to early extubation and 20 patients who were extubated in the operating room. Nowadays, if patients have had mild body hypothermia (30° to 34° C) during perfusion, we prefer to extubate them 1 to 4 hours after arrival in the postoperative intensive care unit. The beneficial effects of early extubation on ventricular performance were demonstrated in 1988 by the group from Duke University. ⁶

We appreciate the work of the group from the Toronto Hospital because their subject is of great importance in undeveloped areas like ours in northeast Brazil.

References

1. Cheng DCH, Karski J, Peniston C, et al. Morbidity outcome in early versus conventional tracheal extubation after coronary artery bypass grafting: a prospective randomized controlled trial. J Thorac Cardiovasc Surg 1996;112:775.
   
2. Jucá ER, Rolim JM, Monte L, et al. Extubação precoce após cirurgia cardiaca com C.E.C.. Rev Col Bras Cirurg 1976;julho-agosto;163.
   
3. Midell AI, Skinner DB, De Buer A, Bermudez G. Review of pulmonary problems following valve replacement in 100 conservative patients: case against routine use of assisted ventilation. Ann Thorac Surg 1974;18:278.
   
4. Barash PG, Lescovich F, Katz J, Falner WS, Stansel HC. Early extubation following pediatric cardiothoracic operation: a viable alternative. Ann Thorac Surg 1980;29:228.[Abstract]
   
5. Jucá ER. Extubação traqueal precoce após cirurgia de revascularização do miocárdio com enxerto de veia safena aortocoronária [thesis]. Ceará, Brazil: University of Ceará; 1980.
   
6. Gall J Jr, Olsen CD, Reves JC, et al. Beneficial effects of endotracheal extubation on ventricular performance. J Thorac Cardiovasc Surg 1988;95:819-27.[Abstract]
   

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Jucá, R. Articles by Monte, L. Search for Related Content PubMed PubMed Citation Articles by Jucá, R. Articles by Monte, L.