Comparison of Short-Term Outcomes of Extubation in the Operating Room and Extubating in the Intensive Care Unit After Cardiac Surgery: Systematic Review and Meta-Analysis.

This meta-analysis compares short-term outcomes of immediate extubation in the operating room (ORE) versus extubation in the intensive care unit (ICUE) following cardiac surgery. Analyzing 14 studies with 679,749 patients, the findings indicate that ORE is associated with shorter cardiopulmonary bypass times, as well as reduced ICU and hospital stays, without increasing rates of reintubation, prolonged ventilation, or hospital readmission. While overall analysis suggested lower postoperative stroke and short-term mortality rates in the ORE group, these differences were not significant in subgroup analyses controlling for confounding factors. Notably, subgroup analyses revealed a higher rate of reoperation for bleeding in ORE patients, highlighting the need for careful hemostasis monitoring. The study concludes that ORE can be safely performed in selected patients, offering potential benefits in recovery time, though further research is needed to optimize patient selection and protocols.