Immediate extubation in the operating room improved outcomes after cardiac surgery with cardiopulmonary bypass. The findings came from a study presented at the European Society of Cardiology (ESC) Congress 2025.

The analysis included 3,681 patients who underwent cardiac surgery. Of these, 246 (6.7%) were extubated in the operating room. Propensity score matching created 454 comparable patients, with 227 in each group. 

Patients extubated in the operating room needed fewer blood products. Packed red blood cell use was 0.64 units compared with 1.18 units (p = 0.003). Fresh frozen plasma use was 0.07 units compared with 0.59 units (p < 0.001). Use of platelets, fibrinogen, and PPSB was lower but not significant.

Intensive care unit stay was shorter with immediate extubation (1.37 vs 1.89 days, p < 0.001). Hospital stay was similar (10.15 vs 10.59 days, p = 0.65). Delirium and re-thoracotomy rates were lower but not significant. Immediate extubation appears safe and helps conserve ICU and blood resources.