Q What is the standard of care for cardiac surgery recovery in the area of weaning and extubation? In our facility, the physicians do not want us to wean until 24 hours after surgery, but I have been reading about rapid weaning and extubation in this patient population.

A Mary Kay Jiricka, RN, MSN, APN-BC, replies:

Cardiovascular surgery, whether coronary artery bypass grafting or valvular repair or replacement, continues to be a mainstay of treatment for individuals who experience coronary artery disease and/or valvular disease. Critical care nurses have always been the center of care for this patient population. In this capacity, nurses have been responsible for all aspects of patient care. In the immediate postoperative phase, critical care nurses have been responsible for assessing and monitoring the patient’s response to recovery from anesthesia, hemodynamic monitoring, administration of intravenous fluids, titration of vasoactive therapy, and the weaning and extubation from...

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