Con: Extubating in the OR after cardiac surgery is not necessary

CARDIAC SURGERY PATIENTS are among the highest risk patients for postoperative pulmonary complications, acute kidney injury, and increased length of hospital stay.1 In an attempt to decrease these risks, enhanced recovery or fast-track pathways after cardiac surgery have gained traction in recent years. Early extubation is one area of such a pathway that has been shown to decrease the length of stay and reduce healthcare costs in this population.2 While most will agree that extubation within 6 hours is ideal after uncomplicated cardiac surgery, there has been an increasing push to take it one step further and provide routine on-table extubation (OTE) after cardiac surgery.