A Comparative Study Between Early And Conventional Tracheal Extubation After Coronary Artery Bypass Grafting

Abstract

The postoperative period after coronary artery bypass graft surgery is an extension of the intraoperative care, in the operating room the cardiopulmonary system was supported by the cardiopulmonary bypass and in the cardiovascular ICU the process is completed by mechanical ventilation, and for decades overnight mechanical ventilation was used as a standard postoperative care, the rationale for intentionally prolonging ventilatory support was that it minimized episodes of respiratory insufficiency, hypertension and patient anxiety, also it was a standard of care due to the common practice of giving high dose opioids for cardiac anesthesia as opioids proved great success in minimizing pain and providing hemodynamic stability, however these benefits have a parallel delay in • regaining the patient consciousness and his or her normal . respiratory function. On the other hand mechanical ventilation itselfhas its own problems like decreasing the venous return and cardiac output, marked hemodynamic instability and cardiovascular stimulation if there is not adequate level of sedation.