ArticleCritical care explorations2023
Risk Factors for Extubation Failure After Pediatric Cardiac Surgery and Impact on Outcomes: A Multicenter Analysis.
Article in Critical care explorations, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Oral Versus Nasal Intubation in Infants and Young Children with Heart Disease: A Systematic Review and Meta-analysis.Pediatric cardiology · 2026Pooled it
- Association of Prophylactic Corticosteroids with Post-Extubation Outcomes in Pediatric Cardiac Critical Care: A Retrospective Propensity-Weighted Cohort Study.Journal of clinical medicine · 2026Article
- Rapid Shallow Breathing Index as a Predictor of Extubation Outcomes After Pediatric Cardiac Surgeries.Children (Basel, Switzerland) · 2026Article
- Overnight extubation and risk of extubation failure in patients in the pediatric intensive care unit: an exploratory review.Frontiers in pediatrics · 2025Review
- Early extubation after pediatric cardiac surgery.Anesthesia and pain medicine · 2024Article
- High-Risk Extubation Readiness Testing for Children With Cardiac Critical Illness.Respiratory care · 2024Article
- Predictors and outcomes of extubation failures in a pediatric intensive care unit: A retrospective study.Journal of Taibah University Medical Sciences · 2024Article
- Development of a clinical prediction tool for extubation failure in pediatric cardiac intensive care unit.Frontiers in pediatrics · 2024Article
- Ultrasound predictors of extubation outcomes in pediatric cardiac surgery: A prospective evaluation of lung, diaphragmatic, and cardiac ultrasound.Annals of pediatric cardiologyArticle
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
importanceExtubation failure (EF) after pediatric cardiac surgery is associated with increased morbidity and mortality.
objectivesWe sought to describe the risk factors associated with early (< 48 hr) and late (48 hr ≤ 168 hr) EF after pediatric cardiac surgery and the clinical implications of these two types of EF. DESIGN SETTING AND
participantsRetrospective cohort study using prospectively collected clinical data for the Pediatric Cardiac Critical Care Consortium (PC4) Registry. Pediatric patients undergoing Society of Thoracic Surgeons benchmark operation or heart transplant between 2013 and 2018 available in the PC4 Registry were included. MAIN OUTCOMES AND MEASURES: We analyzed demographics and risk factors associated with EFs (primary outcome) including by type of surgery. We identified potentially modifiable risk factors. Clinical outcomes of mortality and length of stay (LOS) were reported.
resultsOverall 18,278 extubations were analyzed. Unplanned extubations were excluded from the analysis. The rate of early EF was 5.2% (948) and late EF was 2.5% (461). Cardiopulmonary bypass time, ventilator duration, airway anomaly, genetic abnormalities, pleural effusion, and diaphragm paralysis contributed to both early and late EF. Extubation during day remote from shift change and nasotracheal route of initial intubation was associated with decreased risk of early EF. Extubation in the operating room was associated with an increased risk of early EF but with decreased risk of late EF. Across all operations except arterial switch, EF portrayed an increased burden of LOS and mortality. CONCLUSION AND RELEVANCE: Both early and late EF are associated with significant increase in LOS and mortality. Study provides potential benchmarking data by type of surgery. Modifiable risk factors such as route of intubation, time of extubation as well as treatment of potential contributors such as diaphragm paralysis or pleural effusion can serve as focus areas for reducing EFs.
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