1. Ivica Stefanovski, Klinicka Bolnica Agibadem Sistina-Skopje, Macedonia
Background: Fast-track following cardiac surgery is a complex intervention involving several components of care during cardiac anesthesia and in the postoperative period, with the ultimate aim of early extubation after surgery, to help in reducing postoperative complications, to reduce length of stay in the intensive care unit and in the hospital. The Society of Thoracic Surgeons uses a 6-hour benchmark for early extubation.
Methods: A multidisciplinary extubation protocol was created. The protocol was applied to all elective cardiac surgery patients in the group. The study is both retrospective and prospective. The number of the patients enrolled is 100. Additional primary and secondary outcomes were measured. Patients were excluded if they experienced events that contraindicated application of the protocol. All statistical analysis was performed using STATA 12.0 (StataCorp, College Station, TX). Descriptive analysis was performed using Student's t-tests.
Results: Median extubation time was reduced by 35%. Intensive care unit was reduced from 2 to 1 day. Reintubation rate was similar and nonsignificant in both groups. The rate of ventilator associated pneumonia was reduced. Those with longer intubation durations had a higher STS-predicted risk of morbidity and mortality.
Conclusion: Extubation within 6 hours as compared to conventional extubation practices has been linked to reductions in infectious complications, renal failure, stroke, ICU readmission, reintubation, and operative mortality. Initiatives to reduce ventilator time after surgery have made a substantive effect on cardiac surgery outcomes. It is safe, effective and cost beneficial in both coronary and valvular patients.
Ključne reči :
Informatika u Biomedecini 2023