Fast-track recovery program after cardiac surgery in a teaching hospital: a quality improvement initiative

Patryck Lloyd-Donald, Wen-Shen Lee, James W Hooper, Dong Kyu Lee, Alice Moore, Nikhil Chandra, Peter McCall, Siven Seevanayagam, George Matalanis, Stephen Warrillow, Laurence Weinberg, Patryck Lloyd-Donald, Wen-Shen Lee, James W Hooper, Dong Kyu Lee, Alice Moore, Nikhil Chandra, Peter McCall, Siven Seevanayagam, George Matalanis, Stephen Warrillow, Laurence Weinberg

Abstract

Objective: Fast-track cardiac anesthesia (FTCA) is a technique that may improve patient access to surgery and maximize workforce utilization. However, feasibility and factors impacting FTCA implementation remain poorly explored both locally and internationally. We describe the specific intraoperative and postoperative protocols for our FTCA program, assess protocol compliance and identify reasons for FTCA failure.

Results: We tested the program in 16 patients undergoing elective cardiac surgery requiring cardiopulmonary bypass. There was 100% compliance with the FTCA protocols. Four (25%) patients successfully completed the FTCA protocol (extubated < 4 h postoperatively and discharged from the intensive care unit on the same operative day).

Keywords: Cardiac anesthesia; Fast-track anesthesia; Perioperative flow; Quality improvement; Resource allocation.

Conflict of interest statement

All authors declare no financial or non-financial competing interests.

Figures

Fig. 1
Fig. 1
Fast-track cardiac protocol at completion of surgery. PaO2 partial pressure of oxygen in arterial blood, FiO2 fraction of inspired oxygen, PaCO2 partial pressure of carbon dioxide in arterial blood
Fig. 2
Fig. 2
Fast-track cardiac anesthesia (FTCA) feasibility

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Source: PubMed

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