{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:27:28Z","timestamp":1780100848762,"version":"3.54.0"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,2,14]],"date-time":"2019-02-14T00:00:00Z","timestamp":1550102400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Werner Reichenberger Foundation for Child Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>The aim of this study was to investigate the impact of an early extubation strategy on the outcome following extracardiac total cavopulmonary connection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>From 1999 through 2017, 458 patients underwent extracardiac total cavopulmonary connection; 257 (56%) patients were managed with an early extubation strategy adopted in 2009 (group A). Their outcome was compared with those of 201 (44%) patients treated before 2009 (group B). In group A, the outcome of unstable patients, defined as &gt;75th percentile for volume administered and inotrope scores, was compared with those of stable patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Ventilation time (median: 4\u2009h vs 16\u2009h, P\u2009&lt;\u20090.001), fluid volume administered during the first 24\u2009h (mean: 110\u2009ml\/kg vs 164\u2009ml\/kg, P\u2009=\u20090.003), chest tube duration (median: 3\u2009days vs 4\u2009days, P\u2009=\u20090.028) and length of intensive care unit stay (median: 6\u2009days vs 7\u2009days, P\u2009=\u20090.001) were less in group A than in group B. The reintubation rate (7% vs 6%, P\u2009=\u20090.547) and early mortality (0.8% vs 1.5%, P\u2009=\u20090.465) were similar between groups. The 80 unstable group A patients received more inotropic support (P\u2009&lt;\u20090.001) and fluid volume (P\u2009&lt;\u20090.001) than stable patients, but the ventilation time (6\u2009h vs 5\u2009h, P\u2009=\u20090.220), the reintubation rate (10% vs 6%, P\u2009=\u20090.283) and the length of intensive care unit stay (7\u2009days vs 6\u2009days, P\u2009=\u20090.590) were similar. In unstable patients, mean arterial pressure before extubation was significantly lower than stable patients (P\u2009=\u20090.001). However, mean arterial pressure in unstable patients increased significantly (P\u2009&lt;\u20090.001) soon after extubation, and became similar to the value in stable patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Early extubation following extracardiac total cavopulmonary connection improves postoperative haemodynamics and recovery regardless of the initial haemodynamic status.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivz010","type":"journal-article","created":{"date-parts":[[2019,1,10]],"date-time":"2019-01-10T15:10:42Z","timestamp":1547133042000},"page":"85-92","source":"Crossref","is-referenced-by-count":18,"title":["Early extubation improves outcome following extracardiac total cavopulmonary connection"],"prefix":"10.1093","volume":"29","author":[{"given":"Masamichi","family":"Ono","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany"},{"name":"Department of Cardiovascular Surgery, Insure (Institute for Translational Cardiac Surgery), German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanimir","family":"Georgiev","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melchior","family":"Burri","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany"},{"name":"Department of Cardiovascular Surgery, Insure (Institute for Translational Cardiac Surgery), German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt","family":"Mayr","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany"},{"name":"Department of Cardiovascular Surgery, Insure (Institute for Translational Cardiac Surgery), German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Cleuziou","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany"},{"name":"Department of Cardiovascular Surgery, Insure (Institute for Translational Cardiac Surgery), German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen, Munich, 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