Fast-Track Extubation Eligibility Score (Cardiac Surgery)
- Fast-Track Extubation Eligibility Score (Cardiac Surgery)
Use this tool to estimate readiness for early or operating-room extubation after adult cardiac surgery. It combines evidence-informed bedside criteria (hemodynamics, gas exchange, bleeding, neurological status) with perioperative predictors reported in the literature to categorize eligibility as Eligible now, Borderline—optimize, or Not eligible now.
- Fast-Track Extubation (Cardiac Surgery): Explanation and Clinical Context
Early extubation (commonly within 6–8 hours, or in the operating room) is a cornerstone of Enhanced Recovery After Cardiac Surgery (ERACS) programs. Key readiness criteria include low vasoactive support (VIS ≤16.5), controlled bleeding (<150 mL/h), normothermia, intact neurological function, and adequate gas exchange. Favorable perioperative predictors include younger age, lower BMI, higher albumin, absence of lung disease and diabetes, less-invasive or isolated CABG surgery, elective case, and lower fentanyl dose. The score stratifies readiness into actionable categories (Eligible, Borderline, Not eligible) and provides automatic safety flagging for instability.
References:
Subramaniam K, et al. Predictors of operating room extubation in adult cardiac surgery. J Thorac Cardiovasc Surg. 2017;154(5):1656–1665.e2.
Bauer SJ, et al. Fast-track extubation in minimally invasive cardiac surgery. Front Cardiovasc Med. 2025.
Zhao Y, et al. Vasoactive–Inotropic Score predicts early extubation after cardiac surgery. BMC Anesthesiol. 2024.
Hayanga HK, et al. Should patients be extubated in the operating room after cardiac surgery? J Thorac Dis. 2021.
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