Date of Award

8-1-2005

Document Type

Thesis

Degree Name

Master of Science (MS)

Department

Nursing

Abstract

The purpose of this study was to identify contributing factors that cause coronary artery bypass graft (CABG) patients to remain intubated longer than eight hours. Current practice in CABG anesthesia advocates tracheal extubation within one to eight hours after surgery. With the advances made in anesthetic techniques and post-operative analgesia, the CABG population should consistently be extubated within the eight hour time frame.

A retrospective medical chart review of 30 CABG patients remaining intubated longer than eight hours was conducted. A study group of 30 patients extubated within eight hours was used for comparison.

The subjects reviewed for both groups were males and females ranging in age from 40 to 80 years. Subjects with an ASA (American Society of Anesthesiologists) preoperative classificati on of III and IV were allowed in the study. Preoperative variables including age, gender, height, and weight were assessed. Intraoperative factors included number of bypass grafts, time and use of bypass pump, as well as total drug dosages and use of vasopressors. Postoperative variables studied consisted of the use of pain medication, cardiac arrhythmias, and total chest tube drainage in the first three postoperative hours.

The prevalence of variables were determined using correlation and regression analysis, t-tests and ANOVA to examine the relationship between each of the variables. The study sought to support that preoperative variables, such as age; intraoperative variables, such as total surgery time; and postoperative variables, such as chest tube drainage all contribute to prolonged intubation times. However, the only variable showing statistical significance when related to time until extubation was age. All other variables showed no statistical significance.

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