Massachusetts General Hospital
We are studying whether waking patients up and removing the breathing tube (also known as "extubation") in the operating room after cardiac surgery improves postoperative recovery without causing harm.
This is a pragmatic, randomized controlled trial comparing OR extubation versus ICU extubation among adults undergoing elective cardiac surgery.
Inclusion Criteria: * Adults (age 18+) scheduled for elective cardiac surgery requiring cardiopulmonary bypass * Low perioperative risk defined as STS Predicted Risk of Mortality (PROM) ≤ 3% based on the latest STS Adult Cardiac Surgery Database (ACSD) Risk Calculator * Deemed appropriate for OR extubation preoperatively by the attending cardiac surgeon * Able to provide informed consent Exclusion Criteria: * Underlying pulmonary disease requiring use of home supplemental oxygen * Pre-capillary pulmonary hypertension (mPAP ≥ 25 mmHg or PVR \> 2 Wood units) on most recent right heart cathete…
Immediate extubation in the operating room (OR) at the conclusion of cardiac surgery
Extubation in the intensive care unit (ICU) within 6 hours of leaving the operating room after cardiac surgery
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