A Comparison of Patients Undergoing On- vs. Off-Pump Coronary Artery Bypass Surgery Managed with a Fast-Track Protocol

Abstract

The purpose of this study was to compare patients who underwent on- vs. off-pump coronary artery bypass surgery managed with a fast-track protocol. Between September 2012 and December 2018, n = 3505 coronary artery bypass surgeries were managed with a fast-track protocol in our specialized post-anesthesia care unit. Propensity score matching was applied and resulted in two equal groups of n = 926. There was no significant difference in ventilation time (on-pump 75 (55–120) min vs. off-pump 80 (55–120) min, p = 0.973). We found no statistically significant difference in primary fast-track failure in on-pump (8.2% (76)) vs. off-pump (6% (56)) groups (p = 0.702). The secondary fast-track failure rate was comparable (on-pump 12.9% (110) vs. off-pump 12.3% (107), p = 0.702). There were no significant differences between groups in regard to the post-anesthesia care unit, the intermediate care unit, and the hospital length of stay. Postoperative outcome and complications were also comparable, except for a statistically significant difference in PACU postoperative blood loss in on-pump (234 mL) vs. off-pump (323 mL, p < 0.0001) and red blood cell transfusion (11%) and (5%, p < 0.001), respectively. Our results suggest that on- and off-pump coronary artery bypass surgery in fast-track settings are comparable in terms of ventilation time, fast-track failure rate, and postoperative complications rate.

Retrospectively analyze and compare the efficacy and safety of thoracoscopic-assisted Nuss repair of pectus excavatum under intubation anesthesia and non-intubation anesthesia

“…Fast track surgery (FTS) is the latest rehabilitation concept proposed in recent years ( 21 ). It is an evidence-based medical approach using surgery, anesthesia, care, nutrition, and cooperation with other departments to optimize the perioperative management of the clinical pathway so as to alleviate perioperative stress reactions, reduce postoperative complications, shorten the length of stay, and promote the recovery of patients ( 22 , 23 ). With the development of the FTS concept, PE repair has evolved from the traditional Ravitch sternal elevation to thoracoscopic-assisted Nuss minimally invasive repair ( 24 ).…”

Postoperative Weight Gain within Enhanced Recovery after Cardiac Surgery

“…Swan-Ganz catheters were spared to patients with a low ejection fraction (EF) of ≤35% or impaired right ventricle (RV) function or tricuspid valve (TV) surgery. More details regarding anesthesia and postoperative analgesia were published previously [ 10 , 11 ].…”

“…The early experimental results were published in 2008 [ 13 ]. Many aspects of this concept were tested and published [ 10 , 11 , 12 , 14 , 15 , 16 , 17 ]. This protocol was dynamically developed to match ERACS evolution over the time.…”