OBJECTIVES: Fast-track cardiac anaesthesia programs aiming at early tracheal extubation have not only been linked to a decrease in intensive care unit and hospital length of stay but also to a decrease in morbidity and mortality as well as a containment of rising medical costs. General recommendations for the inclusion criteria concerning fast-track programs are not available. METHODS: The present study determined the factors influencing the time to extubation in patients undergoing a newly implemented fast-track protocol. Seventy-nine patients were retrospectively studied. Successful fast track was defined as time to extubation within 75 min after admission to ICU. RESULTS: Sixty patients fulfilled the successful fast-track criteria with a mean time to extubation of 43.9 min (range 15-75 min). Nineteen patients needed more than 75 min to be weaned from the respirator with a mean time to extubation of 135 min (range 90-320 min). Analysis of pre- and intraoperative factors revealed that these groups differed only with respect to preoperative cerebral oxygen saturation levels: 67.7 ± 5.2 versus 60.8 ± 7.4%. CONCLUSIONS: Cerebral oxygen saturation assessment prior to cardiac surgery is significantly related to time to extubation and may thus be used to stratify candidates in fast-track programs.
OBJECTIVES: Fast-track cardiac anaesthesia programs aiming at early tracheal extubation have not only been linked to a decrease in intensive care unit and hospital length of stay but also to a decrease in morbidity and mortality as well as a containment of rising medical costs. General recommendations for the inclusion criteria concerning fast-track programs are not available. METHODS: The present study determined the factors influencing the time to extubation in patients undergoing a newly implemented fast-track protocol. Seventy-nine patients were retrospectively studied. Successful fast track was defined as time to extubation within 75 min after admission to ICU. RESULTS: Sixty patients fulfilled the successful fast-track criteria with a mean time to extubation of 43.9 min (range 15-75 min). Nineteen patients needed more than 75 min to be weaned from the respirator with a mean time to extubation of 135 min (range 90-320 min). Analysis of pre- and intraoperative factors revealed that these groups differed only with respect to preoperative cerebral oxygen saturation levels: 67.7 ± 5.2 versus 60.8 ± 7.4%. CONCLUSIONS: Cerebral oxygen saturation assessment prior to cardiac surgery is significantly related to time to extubation and may thus be used to stratify candidates in fast-track programs.
Authors: Davy C H Cheng; Claus Wall; George Djaiani; Raul A Peragallo; Jo Carroll; Cindy Li; David Naylor Journal: Anesthesiology Date: 2003-03 Impact factor: 7.892
Authors: M J London; A L Shroyer; J R Coll; S MaWhinney; D A Fullerton; K E Hammermeister; F L Grover Journal: Anesthesiology Date: 1998-06 Impact factor: 7.892