Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Ultra-fast-track anesthetic technique facilitates operating room extubation in patients undergoing off-pump coronary revascularization surgery
Autore:
Djaiani, GN; Ali, M; Heinrich, L; Bruce, J; Carroll, J; Karski, J; Cusimano, RJ; Cheng, DCH;
Indirizzi:
Univ Toronto, Univ Hlth Network, Dept Anesthesia, Toronto, ON, Canada UnivToronto Toronto ON Canada ork, Dept Anesthesia, Toronto, ON, Canada Univ Toronto, Univ Hlth Network, Div Cardiovasc Surg, Toronto, ON, Canada Univ Toronto Toronto ON Canada Div Cardiovasc Surg, Toronto, ON, Canada Duke Univ, Med Ctr, Dept Anesthesiol, Div Cardiothorac Anesthesia, Durham,NC 27710 USA Duke Univ Durham NC USA 27710 ardiothorac Anesthesia, Durham,NC 27710 USA
Titolo Testata:
JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA
fascicolo: 2, volume: 15, anno: 2001,
pagine: 152 - 157
SICI:
1053-0770(200104)15:2<152:UATFOR>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
THORACIC EPIDURAL ANALGESIA; INTENSIVE-CARE UNIT; CARDIAC-SURGERY; BYPASS-SURGERY; STAY; COST; TRIAL;
Keywords:
general anesthesia; thoracic epidural; fast-track; operating room extubation; drugs; remifentanil; cardiac surgery; off-pump coronary artery bypass graft surgery; monitoring; temperature;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Ali, M Toronto Gen Hosp, 585 Univ Ave,BW4-646, Toronto, ON M5G 2C4, CanadaToronto Gen Hosp 585 Univ Ave,BW4-646 Toronto ON Canada M5G 2C4 ada
Citazione:
G.N. Djaiani et al., "Ultra-fast-track anesthetic technique facilitates operating room extubation in patients undergoing off-pump coronary revascularization surgery", J CARDIOTHO, 15(2), 2001, pp. 152-157

Abstract

Objective: To determine if implementation of ultra-fast-track anesthetic (UFTA) technique facilitates operating room extubation in patients undergoing off-pump coronary artery bypass graft (CABG) surgery. Design: Retrospective review. Setting: Referral center for cardiovascular surgery at a university hospital. Participants: Thirty-seven patients undergoing off-pump CABG surgery. Interventions: Two groups represented UFTA (n = 10) and standard anesthetic (controls, n = 27) techniques. Anesthesia was conducted with propofol, remifentanil, vecuronium, and thoracic epidural analgesia in the UFTA group and thiopental, fentanyl, pancuronium, and isoflurane in the control group. Active temperature control was an integral part of the UFTA technique but not the standard technique. The active temperature control included intravenous fluid warmer, prewarmed skin preparation, humidified inspired gases, a circulating water warming blanket, and a forced-air warmer, along with the maintenance of the operating room temperature at 24 degreesC. The control group was managed with an intravenous fluid warmer, and the ambient temperature remained constant (20 degreesC). Patients who did not satisfy extubation criteria within 30 minutes from the end of surgery were sedated and transferred to the intensive care unit (ICU). Measurements and Main Results: All patients in the UFTA group and 2 in thecontrol group were extubated in the operating room immediately after surgery. None of the patients required reintubation. There was no significant difference in postextubation PaO2 and PaCO2 between the groups. Nasopharyngeal temperature decreased from 36.7 +/- 0.4 degreesC to 36.4 +/- 0.3 degreesCin the UFTA group and from 36.6 +/- 0.5 degreesC to 35.6 +/- 0.4 degreesC in the control group (p < 0.0001). Bradycardia occurred significantly more often in the UFTA group but there was no difference in episodes of hypotension. There were no perioperative deaths. Patients who were extubated in theoperating room required lower nurse-to-patient acuity ratio (1:2) in the ICU. No difference was found in ICU and hospital length of stay. Conclusions: Implementation of UFTA technique provided adequate hemodynamic control and facilitated operating room extubation in all patients. The impact of UFTA on earlier patient discharge and actual cost savings within a fully integrated post-cardiac surgery unit requires further evaluation. Copyright (C) 2001 by W.B. Saunders Company.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/01/20 alle ore 10:41:44