Back to Search
Start Over
Variation in Implementation and Outcomes of Early Extubation Practices After Infant Cardiac Surgery
- Source :
- The Annals of Thoracic Surgery. 107:1434-1440
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Background The Pediatric Heart Network Collaborative Learning Study (PHN CLS) increased early extubation after infant tetralogy of Fallot (TOF) and coarctation repair overall at participating sites through implementing a clinical practice guideline (CPG). We evaluated variability across sites in CPG implementation and outcomes. Methods Patient characteristics and outcomes (time to extubation, length of stay [LOS]) were compared across sites, including pre-CPB to post-CPG changes. Semistructured interviews were analyzed to assess similarities and differences in implementation strategies across sites. Results A total of 322 patients were included (4 active sites, 1 model site). Patient characteristics were similar across active sites, whereas pre-CPG median time to extubation varied from 15.4 to 35.5 hours. All active sites had a significant post-CPG decline (p Conclusions All PHN CLS sites successfully reduced time to extubation. The magnitude of change varied and may be partly explained by different CPG implementation strategies. These data can guide CPG dissemination and design of future improvement projects.
- Subjects :
- Pulmonary and Respiratory Medicine
medicine.medical_specialty
business.industry
Patient characteristics
Airway Extubation
Guideline
030204 cardiovascular system & hematology
medicine.disease
Cardiac surgery
Clinical Practice
03 medical and health sciences
0302 clinical medicine
030228 respiratory system
CpG site
Emergency medicine
medicine
Surgery
Cardiology and Cardiovascular Medicine
business
Tetralogy of Fallot
Cohort study
Subjects
Details
- ISSN :
- 00034975
- Volume :
- 107
- Database :
- OpenAIRE
- Journal :
- The Annals of Thoracic Surgery
- Accession number :
- edsair.doi...........24bcce64268ab597776bc02af90e1374