• Rev Bras Ter Intensiva · Jan 2019

    Comparative Study

    Impact of fast-track management on adult cardiac surgery: clinical and hospital outcomes.

    • Cibelle Andrade Lima, Maria Karoline Ritchrmoc, Wagner Souza Leite, Diogo André Rodrigues Galdino Silva, Wildberg Alencar Lima, Shirley Lima Campos, and Andrade Armele Dornelas de AD Universidade Federal do Rio Grande do Norte - Natal (RN), Brasil. Universi.
    • Universidade Federal do Rio Grande do Norte - Natal (RN), Brasil.
    • Rev Bras Ter Intensiva. 2019 Jan 1; 31 (3): 361-367.

    ObjectiveTo compare the impact of two fast-track strategies regarding the extubation time and removal of invasive mechanical ventilation in adults after cardiac surgery on clinical and hospital outcomes.MethodsThis was a retrospective cohort study with patients undergoing cardiac surgery. Patients were classified according to the extubation time as the Control Group (extubated 6 hours after admission to the intensive care unit, with a maximum mechanical ventilation time of 18 hours), Group 1 (extubated in the operating room after surgery) and Group 2 (extubated within 6 hours after admission to the intensive care unit). The primary outcomes analyzed were vital capacity on the first postoperative day, length of hospital stay, and length of stay in the intensive care unit. The secondary outcomes were reintubation, hospital-acquired pneumonia, sepsis, and death.ResultsFor the 223 patients evaluated, the vital capacity was lower in Groups 1 and 2 compared to the Control (p = 0.000 and p = 0.046, respectively). The length of stay in the intensive care unit was significantly lower in Groups 1 and 2 compared to the Control (p = 0.009 and p = 0.000, respectively), whereas the length of hospital stay was lower in Group 1 compared to the Control (p = 0.014). There was an association between extubation in the operating room (Group 1) with reintubation (p = 0.025) and postoperative complications (p = 0.038).ConclusionPatients undergoing fast-track management with extubation within 6 hours had shorter stays in the intensive care unit without increasing postoperative complications and death. Patients extubated in the operating room had a shorter hospital stay and a shorter stay in the intensive care unit but showed an increase in the frequency of reintubation and postoperative complications.

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