Fast-track cardiac care for adult cardiac surgical patients

Zhu, Fang; Lee, Anna; Chee, Yee Eot

doi:10.1002/14651858.cd003587.pub2

Cited by 81 publications

(80 citation statements)

References 70 publications

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“…Although numerous studies have addressed reducing extubation, most involved too few patients to detect a Readiness bundle score Readiness bundle score difference in mortality. 9 In a 2012 meta-analysis, Zhu et al 9 concluded that mortality and morbidity did not differ for patients extubated early (within 8 hours) and patients extubated later. However, patients extubated early had a significantly shorter stay in the intensive care unit (although not in the hospital) than patients extubated later.…”

Section: Discussionmentioning

confidence: 99%

Improving Patients’ Readiness for Coronary Artery Bypass Graft Surgery

Chaisson

Sanford

Boss

et al. 2014

Critical Care Nurse

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Background Preoperative interventions improve outcomes for patients after coronary artery bypass surgery (CABG). Objective To reduce mortality for patients undergoing urgent CABG. Methods Eight centers implemented preoperative aspirin and statin, preinduction heart rate less than 80/min, hematocrit greater than 30%, blood sugar less than 150 mg/dL (8.3 mmol/L), and delayed surgery at least 3 days after a myocardial infarction. Data were collected on the last 150 isolated, urgent CABGs at each center (n=1200). A “bundle” score of 0 to 100 was calculated for each patient to represent the percentage of interventions used. Results Scores ranged from 33 to 100. About 56% of patients had a perfect score. Crude mortality and composite rates were lower in patients with higher scores, but once adjusted for patient and disease characteristics, the difference in scores was not significant. Higher scores were associated with shorter intubation: 6.0 hours (score 100), 8.0 hours (score 80–99), 8.4 hours (score<80) (log-rank P<.001). Median length of stay was shorter for patients with higher scores: 5 days (score 100), 6 days (scores 80–99), and 6 days (scores <80) (log-rank P<.001). Conclusion Implementation of interventions to optimize patients’ “readiness for surgery” is associated with shorter intubation times and shorter hospital stays after CABG.

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Section: Discussionmentioning

confidence: 99%

Improving Patients’ Readiness for Coronary Artery Bypass Graft Surgery

Chaisson

Sanford

Boss

et al. 2014

Critical Care Nurse

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show abstract

“…Promoting a rapid, complete recovery and return to normal function through optimal perioperative management is the foundation of ERAS, a key component of which is appropriate analgesia management, based on accurate pain assessment. ERAS has been successfully applied to veterinary medicine (Hasiuk et al 2015) and has made significant contributions to human medicine (Varadhan et al 2010;Spanjersberg et al 2011;Lu et al 2012;Zhu et al 2012). An alternative approach, supported by these data, would be to account for demeanor when applying the preferred validated pain scale.…”

Section: Discussionmentioning

confidence: 99%

The influence of demeanor on scores from two validated feline pain assessment scales during the perioperative period

Buisman

Hasiuk

Gunn

et al. 2017

Veterinary Anaesthesia and Analgesia

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“…The introduction of a fast-track protocol in cardiac surgery for dedicated patients with early extubation, short ICU stay, and coordinated perioperative care also has been reported as effective in reducing costs and perioperative complications. 40 Camp et al reported that the introduction of a quality improvement program that consisted of an extensive bundle of protocols resulted in a shorter time to extubation. Moreover, extubation within 6 hours after surgery was associated with reductions in pneumonia, sepsis, and reintubation and a faster discharge from the ICU and the hospital.…”

Section: Early Extubationmentioning

confidence: 99%