REVIEW: Fast-Tracking Cardiac Surgery.
A "fast track" approach to cardiac surgery can be defined as a perioperative process involving rapid progress from preoperative preparation through surgery and discharge from the hospital. Although highly individualized among the various heart surgery centers, the fast-track process is a team activity. It requires a team of health care providers to interact with the patient at various phases, from admission to discharge. The necessary elements of the fast-track program are choice and the titration of short-acting anesthetic drugs, standardized surgical procedures, early extubation, rewarming and sustained postoperative normothermia, postoperative pain control, early ambulation, alimentation and discharge, and follow-up after discharge. We review the current approaches to some of these aspects of patient care.
Pande
Ravi U
RU
Department of Surgery, Buffalo General Hospital at Kaleida Health, Buffalo, New York, USA.
Nader
Nader D
ND
Donias
Harry W
HW
D'Ancona
Giuseppe
G
Karamanoukian
Hratch L
HL
D000701:Analgesics, Opioid / Q000008:administration & dosage; D000758:Anesthesia / Q000379:methods*; D001831:Body Temperature; D006348:Cardiac Surgical Procedures; D003325:Coronary Care Units; D004434:Early Ambulation; D006801:Humans; D007442:Intubation, Intratracheal; D007902:Length of Stay; D010149:Postoperative Pain / Q000517:prevention & control; D010343:Patient Admission; D010351:Patient Discharge; D010880:Piperidines / Q000008:administration & dosage; D011182:Postoperative Care / Q000379:methods*; D011300:Preoperative Care / Q000379:methods*; D000077208:Remifentanil
D000701:Analgesics, Opioid; D010880:Piperidines; D000077208:Remifentanil