{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T04:07:17Z","timestamp":1792728437690,"version":"4.5.0"},"reference-count":16,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["World J Pediatr Congenit Heart Surg"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We undertook this study to evaluate the efficacy of an on-table extubation protocol and to assess the magnitude of benefits when implemented as a routine practice in a developing country.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective observational study at a single tertiary care referral hospital was designed to determine the efficacy of an on-table extubation protocol when applied to children undergoing cardiac surgery in the developing world. The study included 226 patients who were 1 month to 18 years of age undergoing cardiac surgery (including grown-up congenital heart disease [GUCHD] patients). Patients with RACHS score\u2009\u2265\u20094, neonates, preoperatively ventilated children, and emergency surgeries were excluded from the study. All pediatric elective cardiac surgical patients belonging to RACHS 1, 2, and 3 categories were considered as potential candidates for on-table extubation. Trial registration: Clinical Trials Registry of India (CTRI\/2020\/07\/026567).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 226 children who underwent elective cardiac surgeries, we were able to extubate 142 patients (62.83%) in the operating room. This included 46.6% (54\/116) infants, 80.8% (38\/47) children less than 5 years of age, 79.3% (46\/58) children between 5 years to 18 years age, and 80% (4\/5) GUCHD. The duration of intensive care unit (ICU) stay, hospital stay, and hospital cost were significantly less in the on-table extubation group (23 [20, 26] hours; 102 [97, 125] hours; INR 2,09,011 [181032, 244298]) as compared with those patients extubated in the ICU within 6\u2005hours (28 [22, 46] hours; 122 [100, 168] hours; INR 2,25,430 [162203, 273831]) and beyond 6\u2005hours (71 [45, 121] hours; 184 [127, 243] hours; INR 2,53,541 [226838, 306871]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This protocol shows a significant reduction in ICU stay, hospital stay, and total hospital cost when compared with either extubation within 6\u2005h in the ICU or delayed extubation (beyond 6\u2005h) in patients undergoing pediatric cardiac surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501351241306032","type":"journal-article","created":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T04:12:59Z","timestamp":1739419979000},"page":"483-492","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Routine Use of an On-Table Extubation Protocol in Pediatric Cardiac Surgery\u2014Our Experience With Life in the Fast Lane"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4240-6705","authenticated-orcid":false,"given":"Jothinath","family":"Kaushik","sequence":"first","affiliation":[{"name":"Department of Cardiac Anesthesiology, G Kuppuswamy Naidu Memorial Hospital, Coimbatore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9706-2077","authenticated-orcid":false,"given":"Raju","family":"Vijayakumar","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anesthesiology, G Kuppuswamy Naidu Memorial Hospital, Coimbatore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pavithra","family":"Ramanath","sequence":"additional","affiliation":[{"name":"Department of Research and Statistics, G Kuppuswamy Naidu Memorial Hospital, Coimbatore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1497-9489","authenticated-orcid":false,"given":"Murugesan Karthik","family":"Babu","sequence":"additional","affiliation":[{"name":"Department of Research and Statistics, G Kuppuswamy Naidu Memorial Hospital, Coimbatore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivasan","family":"Naveen","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, G Kuppuswamy Naidu Memorial Hospital, Coimbatore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janarthanan","family":"Maniyarasu","sequence":"additional","affiliation":[{"name":"Department of Research and Statistics, G Kuppuswamy Naidu Memorial Hospital, Coimbatore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael E.","family":"Nemergut","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2664-1290","authenticated-orcid":false,"given":"Joseph","family":"Dearani","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adult Congenital Heart Surgery, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,2,13]]},"reference":[{"key":"e_1_3_3_2_2","first-page":"48","article-title":"Challenges and opportunities facing medical education","volume":"122","author":"Densen P","year":"2011","unstructured":"Densen P. Challenges and opportunities facing medical education. Trans Am Clin Climatol Assoc. 2011;122:48\u201358. https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3116346\/. 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