SynthesisBMC anesthesiology2025
Different extubation protocols for adult cardiac surgery: a systematic review and pairwise and network meta-analysis.
Synthesis in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
4 citing papers in PubMed.
- Immediate extubation post-surgery in cardiac patients: a retrospective single-center case series and literature review.Journal of cardiothoracic surgery · 2026Review
- Ultra-fast-track anesthesia in cardiac surgery: perioperative outcomes, patient selection, and implementation strategies-a narrative review.Frontiers in cardiovascular medicine · 2026Review
- Review
- Perioperative nursing management of an adult patient with giant right-sided Bochdalek hernia: a case report.Frontiers in medicine · 2026Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundWith the advancement of ultra-fast track anesthesia, early extubation following cardiac surgery has become a prevailing trend. While there are significant benefits associated with early extubation, its high failure rate warrants further investigation, and the effectiveness of various extubation strategies in cardiac surgery still requires validation.
methodsAn extensive literature search was performed in the PubMed, Scopus, Embase, and Web of Science databases, encompassing studies without language restrictions. Eligible studies were those that compared the outcomes of various extubation strategies.
resultsPrimary outcome was the success rate of the extubation protocol. Secondary outcomes were time to extubation, intensive care unit (ICU) length of stay (LOS), complications and mortality rate. Data from 12 studies, which included a total of 1454 participants, were included in the analysis. The pairwise meta-analysis revealed that late extubation was significantly more effective than immediate extubation strategies (relative risk [RR] = 1.52, 95% confidence interval [CI] = 1.21-1.91, P = 0.0001). In the network meta-analysis (NMA), the late extubation protocol was associated with a significantly lower risk of extubation failure compared to early extubation and extubation on the table (RR = 0.76, 95% CI: 0.5-1.16; RR = 0.22, 95% CI: 0.05-0.91). Furthermore, according to the SUCRA plot, late extubation was ranked as the most effective strategy for reducing extubation failure (94%).
conclusionsOur findings indicate that a late extubation strategy, as opposed to early (within a specified time frame) or immediate extubation, is correlate with a substantially higher rate of successful extubation. Despite this, the early extubation strategy seems to offer better cost-effectiveness and safety profiles. The selection of an appropriate extubation strategy should be personalized, taking into account the patient's preoperative characteristics and the circumstances encountered during surgery.
trial registrationThe study protocol adheres to the PRISMA statement and checklist. The protocol was registered at PROSPERO (CRD42024529051).
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