การศึกษาเปรียบเทียบผลลัพธ์ผู้ป่วยที่คัดสรรระหว่างผู้ป่วยผ่าตัดหัวใจแบบเปิด ที่ได้รับการถอดท่อช่วยหายใจออกและที่คาท่อช่วยหายใจออกมาจากห้องผ่าตัด A Comparison Study of Selected Patient Outcomes between Patients Undergoing Open Heart Surgery Extubated and Intubated from Surgery Room

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สุวิมล วงษาจันทร์ มะลิวรรณ ศิลารัตน์ อรทัย สืบกินร วาสนา รวยสูงเนิน

Abstract

The objective of this prospective analytical research was to compare the intensive care unit length of stay (ICU-LOS), the post-surgery hospital length of stay (H-LOS), and post-surgery complications in open heart surgery patients who were extubated and intubated from surgery room. Study sample consisted of 88 patients underwent open heart surgery who were admitted to ICU at Queen Sirikit Heart Center of the Northeast. There were 44 patients in each group who were purposively selected. The inclusion criteria included age at least 18 years, having elective surgery, and the pre-surgery cardiovascular risk score less than 6, evaluated by the EuroSCORE II. Research instruments consisted of 1) demographic characteristics form to collect pre-surgery general information, treatment and surgery information, post-surgery ICU-LOS, and post-surgery H-LOS; 2) the EuroSCORE II, and 3) post-surgery complication record form. Descriptive statistics,        Chi-square, Fisher’s exact test, T-test, and Mann-Whitney U test were used for data analysis.


Study findings revealed that ICU-LOS of the patients who were extubated from surgery room were significantly shorter than the intubated group (MeanExt30.11, SD 17.44; MeanInt 54.42, SD 25.74, p = 0.00). However, the H-LOS and complications after surgery were not different between groups (p = 0.137 and p = 0.05, respectively). The most common post-surgery complications in both groups were atrial fibrillation (Int 18.2%, Ext 20.5%) and pleural effusion (Int 13.6%, Ext 6.8%), and low cardiac output (Int 13.6%, Ext 2.3%). It was evident that some post-surgery complications were more likely to occur in the intubation group. In conclusion, the patients who were extubated from the surgery rooms had the shorter ICU-LOS without different post-surgery complications comparing to those who were intubated from the surgery room. However, there were common complications found in both groups that the ICU nurses should monitor and plan for care to prevent complications after open heart surgery.

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