[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-437506-105":59,"doc-detail-437506-en":129},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":122,"head_meta":124,"extra_data":126,"updated_unix":128},105,"en","outcomes-of-early-extubation-following-fontan-surgery-in-children-a-systematic-review-and-meta-analysis","Outcomes of Early Extubation Following Fontan Surgery in Children - A Systematic Review and Meta-Analysis","","Children with single-ventricle physiology undergo the Fontan procedure yet face postoperative risks. This systematic review and meta-analysis evaluates whether early extubation (planned within six to 12 hours, or immediately in the operating room) is safe and effective versus delayed extubation. Using PRISMA guidance and searching PubMed, Scopus, and Web of Science (2005 to June 2025), it included retrospective cohort studies comparing extubation timing in patients aged 0–18.",{"@graph":69,"@context":121},[70,84,104],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/outcomes-of-early-extubation-following-fontan-surgery-in-children-a-systematic-review-and-meta-analysis/437506/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":98,"encodingFormat":97,"isAccessibleForFree":99,"interactionStatistic":100},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/outcomes-of-early-extubation-following-fontan-surgery-in-children-a-systematic-review-and-meta-analysis/437506.png","ImageObject",300,407,{"name":92,"@type":93},"Mimi","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-29",true,{"@type":101,"interactionType":102,"userInteractionCount":4},"InteractionCounter",{"@type":103},"ViewAction",{"@type":105,"mainEntity":106},"FAQPage",[107,113,117],{"name":108,"@type":109,"acceptedAnswer":110},"What question does the review address about early extubation after Fontan surgery?","Question",{"text":111,"@type":112},"It assesses whether early extubation is safe and effective compared with delayed extubation, focusing on reintubation, mortality, and postoperative recovery outcomes.","Answer",{"name":114,"@type":109,"acceptedAnswer":115},"How was the evidence collected and what study types were included?",{"text":116,"@type":112},"A PRISMA-guided systematic review and meta-analysis searched PubMed, Scopus, and Web of Science from January 1, 2005 to June 2025, and included four retrospective cohort studies that compared early versus delayed extubation in children undergoing the Fontan procedure.",{"name":118,"@type":109,"acceptedAnswer":119},"What outcomes were assessed and what were the key results?",{"text":120,"@type":112},"The review evaluated reintubation, ICU and hospital length of stay, ventilation time, mortality, and postoperative complications. Early extubation was not associated with higher reintubation risk and was associated with shorter ICU stay, with no significant differences in hospital length of stay, pleural effusion, or mortality.","https://schema.org",{"og:url":83,"og:type":123,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":125,"canonical":83},"index,follow",{"doc_id":127,"site_id":62},437506,1790682162,{"code":4,"msg":5,"data":130},{"doc_id":127,"user_id":131,"nickname":92,"user_avatar":132,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":133,"file_id":134,"file_url":135,"file_type":136,"file_size":137,"view_count":4,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":138,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":128,"read_time":41},2336477974920,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Review began 11/14/2025  \nReview ended 11/26/2025  \nPublished 12/06/2025  \n© Copyright 2025  \nOmran et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98561  \nOpen Access Review Article  \nOutcomes of Early Extubation Following Fontan Surgery in Children: A Systematic Review and Meta-Analysis  \nAhmed M. Omran 1, Mohammed M. Elabd 1  \n1. Pediatric Intensive Care Unit, King Fahad Medical City, Riyadh, SAU Corresponding author: Ahmed M. Omran, [dramomran4@gmail.com](dramomran4@gmail.com)  \nAbstract  \nChildren with single-ventricle physiology undergo the Fontan procedure but remain at risk of postoperative complications. Whether early extubation (EE) is safe and beneficial in this population is uncertain.  \nThe objective of this study was to assess the safety and effectiveness of EE compared with delayed extubation after Fontan surgery in children. We conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided systematic review and meta-analysis registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD420251083062) . We searched PubMed, Scopus, and Web of Science from January 1, 2005, to June 2025. Eligible studies compared EE (within six to 12 hours) versus delayed extubation in patients aged zero to 18 years undergoing the Fontan procedure.  \nOutcomes included reintubation (primary), ICU and hospital length of stay, ventilation time, mortality, and postoperative complications. Risk of bias was assessed with Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I); certainty of evidence was rated using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) .  \nFour retrospective cohort studies met the inclusion criteria. EE was not associated with a higher risk of reintubation. EE was associated with a shorter ICU stay. There were no significant differences in hospital length of stay or pleural effusion. Mortality did not differ significantly between groups (pooled RR 0.30, 95% CI 0 .08-1.18; p = 0 .09) . Across outcomes, statistical heterogeneity was low. Overall certainty of evidence was low, primarily due to observational designs and imprecision.  \nIn pediatric Fontan patients, EE appears safe and is associated with a shorter ICU stay without increased reintubation or mortality. These findings support EE within structured fast-track pathways for appropriately selected patients, while highlighting the need for prospective, higher-quality studies.  \nCategories: Cardiology, Cardiac/Thoracic/Vascular Surgery, Pediatric Surgery  \nKeywords: fontan procedure, length of stay in icu, pediatric cardiac surgery outcomes, reintubation, systematic review and meta analysis  \nIntroduction And Background  \nChildren with single-ventricle physiology undergo staged palliation culminating in the Fontan procedure, which reroutes systemic venous return directly to the pulmonary arteries. Although surgical outcomes have improved, patients with a Fontan circulation remain at risk for unique short-and long-term complications that demand careful perioperative management (Rychik et al.) [1] . These physiologic complexities increase the importance of optimizing immediate postoperative care to improve early outcomes and resource use, highlighting the need for Fontan-specific evidence synthesis to guide best practices (Rao et al.) [2] . Positivepressure mechanical ventilation increases intrathoracic pressure and may elevate pulmonary vascular resistance, thereby reducing systemic venous return and cardiac output, effects that can be particularly detrimental in the Fontan circulation, where pulmonary blood flow is passive (Corp et al.) [3] . Minimizing invasive ventilation time and avoiding sustained positive pressures are therefore phy","cbCaidlBpNcgaoYn","https://ap.wps.com/l/cbCaidlBpNcgaoYn","pdf",3167768,12,"English","# Abstract\n## Objective and Methods\n## Outcomes and Findings\n## Conclusions\n# Introduction and Background\n## Fontan physiology and ventilation effects\n## Rationale for early extubation\n## Evidence gap and study aims","[{\"question\":\"What question does the review address about early extubation after Fontan surgery?\",\"answer\":\"It assesses whether early extubation is safe and effective compared with delayed extubation, focusing on reintubation, mortality, and postoperative recovery outcomes.\"},{\"question\":\"How was the evidence collected and what study types were included?\",\"answer\":\"A PRISMA-guided systematic review and meta-analysis searched PubMed, Scopus, and Web of Science from January 1, 2005 to June 2025, and included four retrospective cohort studies that compared early versus delayed extubation in children undergoing the Fontan procedure.\"},{\"question\":\"What outcomes were assessed and what were the key results?\",\"answer\":\"The review evaluated reintubation, ICU and hospital length of stay, ventilation time, mortality, and postoperative complications. Early extubation was not associated with higher reintubation risk and was associated with shorter ICU stay, with no significant differences in hospital length of stay, pleural effusion, or mortality.\"}]","Outcomes of Early Extubation Following Fontan Surgery in Children - A Systematic Review and Meta-Analysis | PDF"]