- Meeting abstract
- Open Access
Improving On Fast-track Protocol for Post Cardiac Surgery Patients
© Tham et al. 2015
- Published: 16 December 2015
- Patient Selection
- Operative Data
- Identify Risk Factor
- Cardiac Patient
- Success Group
Many risk factors have been shown to be independently predictive of the success of fast-track for post cardiac surgery patients. While a safe fast-track protocol is important, patient selection is crucial too in determining the success of fast-tracking patients.
We aim to improve on our fast-track protocol by identifying risk factors affecting extubation time in our institution.
For a total of six months duration, we non-selectively included all cardiac surgery patients admitted through our new post-anaesthesia care unit (PACU). We studied how patients' profile, comorbidities and operative data affect the success rate of extubation.
107 of the total 145 patients admitted to PACU were able to be extubated. However, only 79(54.5%) patients were able to be extubated within four hours. Within the success group, we found that age (OR = 0.912; 95% CI = 0.044-1.779) and duration of ventilator weaning (OR = 0.813; 95% CI = 0.698-0.928) significantly influenced the extubation time with p-value of 0.040 and <0.001 respectively. Within the failure group, age (HR = 1.061; 95% CI = 1.018-1.105), EUROscore II (HR = 2.303; 95% CI = 1.416-3.748), cardiopulmonary bypass time (HR = 1.015; CI 95% 1.005-1.025), aortic cross-clamp time (HR = 1.023; 95% CI = 1.010-1.037) and post-operative inotropic usage (HR = 2.892; 95% CI = 1.637-5.109) significantly affect failure of extubation with p-values of 0.005, 0.001, 0.004, 0.001 and <0.001 respectively.
Through this observational study, we will be able to improve on our pre-operative patient selection based on their age and EUROscore II; and intra-operative decision based on the total cardiopulmonary bypass time and aortic cross-clamp time in order to fast-track cardiac patients by admitting them to PACU. Through this, fast-track protocol can be practiced safely to its many advantages.
Written informed consent was obtained from the patient for publication of this abstract and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.