For patients undergoing elective cardiac surgery, fast-track post-operative protocols can lead to faster extubation (within six hours) as well as shorter intensive care unit (ICU) and hospital stays. This fast-track care can take place in a specialised post-anaesthetic care unit (PACU) rather than an ICU.

In a randomised controlled trial involving 200 patients undergoing elective cardiac surgery, researchers compared the safety and efficacy of fast-track treatment in a specialised PACU and an ICU. Patients meeting the inclusion criteria who were deemed safe for fast-track care were randomised to the PACU or ICU groups. Outcomes were extubation time and length of stay in the PACU/ICU.

Post-operative care in the dedicated PACU led to shorter time to extubation (90 minutes compared to 478) and quicker discharge to a step down unit (3.3 hours compared to a 17.9 hours) without compromising patient safety.

This study suggests cardiac surgery patients who are cared for in a dedicated PACU have a shorter time to extubation and shorter length of stay compared to those cared for in ICU.





Written by Stephanie Harriman, Deputy Medical Editor for BioMed Central.

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  • BabyBoomerWriter

    Anyone given anesthesia for any type of surgery is vulnerable to lingering after-effects. Do any anesthesiologists check up on their patients for problems post-anesthesia? If not, we are missing a chance to collect big data. If someone suffers temporary psychological issues post surgery, such information helps tailor anesthesia for that patient and should be noted in their file. Typically anesthesiologists do not see patients, but this should not preclude an after surgery letter, survey or phone call. Contributing this valuable component of the surgery scenario provides a positive experience for the patient being asked for his/her input. Querying and carefully reviewing feedback several weeks after surgery should be an anesthesiologist’s required contribution to elevating patient care.