Multicenter International Survey on the Clinical Practice of Ultra-Fast-Track Anesthesia with On-Table Extubation in Pediatric Congenital Cardiac Surgery

Akhtar, Murtaza; Momeni, Mona; Székely, Andrea; Hamid, Mohammad; El-Tahan, Mohamed R.; Rex, Steffen

doi:10.1053/j.jvca.2018.07.006

Cited by 28 publications

(25 citation statements)

References 25 publications

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“…Xu et al 21 demonstrated that ultrafast‐track anesthesia shortens extubation time, ICU stays, and hospital stays for children with congenital heart disease and does not increase sedation‐agitation scores or the incidence of adverse reactions. Akhtar et al 22 conducted an online survey to describe global practices for on‐table extubation in pediatric cardiac anesthesia in European and non‐European countries 22 . The authors concluded that fast‐track cardiac anesthesia could be safely used in pediatric patients undergoing the repair of simple atrial and VSDs, although it is feasible in complex surgical cases as well.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of analgesic and sedative effects of remifentanil‐based fast‐track anesthesia in children undergoing transthoracic device closure of ventricular septal defects

Kim

Huang

et al. 2021

J Card Surg

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Background: This study aimed to evaluate the analgesic and sedative effects of remifentanil-based fast-track cardiac anesthesia in children undergoing transthoracic device closure of ventricular septal defects (VSDs). Methods: A retrospective analysis was conducted on 62 children who underwent transthoracic device closure of VSDs from May 2019 to August 2019. The patients were divided into two groups based on the anesthesia methods: group F was given remifentanil-based fast-track cardiac anesthesia, and Group C was given conventional anesthesia. Patient-related clinical data, postoperative analgesia scores, and sedation scores were collected and analyzed. Results: There was no significant difference in intraoperative hemodynamic changes, bispectral index values, postoperative analgesia scores, sedation scores, or the incidence of adverse events between the two groups. Compared with Group C, the duration of mechanical ventilation and the length of intensive care unit (ICU) and hospital stay in group F were significantly lower. Conclusion: Remifentanil-based fast-track anesthesia can be safely applied in children undergoing transthoracic device closure of VSDs, with acceptable postoperative analgesia and sedation effects and shorter mechanical ventilation times and ICU and hospital stays compared with conventional anesthesia. K E Y W O R D S analgesic, fast-track anesthesia, remifentanil, sedative, VSD 1 | BACKGROUND A ventricular septal defect (VSD) is one of the most common cardiac malformations, accounting for 40% of all cardiac malformations. 1 Surgical repair and percutaneous device closure of VSDs are the two most commonly used methods in clinical practice. 2 In recent years, transthoracic device closure of VSDs without extracorporeal circulation, which is another possible treatment, has been widely used and reported in China. Transthoracic device closure of VSDs has the advantages of a small incision, rapid recovery, fewer complications,

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Section: Discussionmentioning

confidence: 99%

Evaluation of analgesic and sedative effects of remifentanil‐based fast‐track anesthesia in children undergoing transthoracic device closure of ventricular septal defects

Kim

Huang

et al. 2021

J Card Surg

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“…Though ventilators are important tools in the armamentarium for the post-operative management of children undergoing surgery for CHD, mechanical ventilation for as short as 18 h leads to significant loss of cross-sectional area of diaphragmatic muscle fibres [30,31]. Every hour of mechanical ventilation increases the risk which gets compounded with the addition of sedatives.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent multicentre international survey [30,31], from both European and non-European countries, a majority of paediatric cardiac anaesthesiologists practice OTE, safety of OTE was perceived as excellent by 70% of the respondents, and none of them had stopped OTE for safety reasons. The practice of OTE varies among institutions, depending on physician preferences, comfort of the entire team, and other logistic considerations.…”

Section: Discussionmentioning

confidence: 99%

Fast tracking after repair of congenital heart defects

Garg¹,

Thareen

Mehmood

et al. 2020

Indian J Thorac Cardiovasc Surg

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Fast tracking after repair of congenital heart defects (CHD) is a process involving the reduction of perioperative period by timely admission, early extubation after surgery, short intensive care unit (ICU) stay, early mobilisation, and faster hospital discharge. It requires a coordinated multidisciplinary team involvement. In the last 2 decades, many centres have adopted the fast tracking strategy in paediatric cardiac population, safely and successfully extubating patients in the OR with reported benefits in terms of reduced morbidity and ICU/hospital stay. In this manuscript, we will review the literature available on early extubation after repair of CHD and share our experience with this approach.

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“…Kısa etkili ajanların kullanımı, minimal invaziv cerrahi yaklaşımlar ve normotermi biraraya geldiğinde kalp cerrahisinde masada ekstübasyon gündeme gelmiştir. Bu yaklaşım hem erişkin hem de konjenital hasta grubunda uygulama imkanı bulmuştur (19,20) . Ancak yeterli sayıda veri olmadığından tüm hasta grupları için güvenliği halen tartışmalıdır.…”

Section: Erken Ekstübasyon Yaklaşımıunclassified

Evolution from Rapid Discharge Program to ERAS Protocols in Cardiovascular Surgery

Salihoğlu¹

2018

IKSST

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Kalp cerrahisindeki gelişmeler mortaliteyi azaltmakla beraber, komplikasyon ve maliyetleri azaltamamıştır. 1990'lı yıllarda başlatılan hızlı taburcu protokolleri yoğun bakım sürecini kısaltmasına rağmen, istenen düzeyde hastane kalış süresi ve morbiditeyi değiştirememiştir. Son yıllarda diğer cerrahi alanlarda oluşturulan ERAS porotokollerinin kalp cerrahisinde de uygulanmasına başlanmıştır. Bu çok yeni uygulamanın oluşturulmasındaki önemli noktalar ve bu konudaki tecrübeler bu derlemede ele alınarak irdelenmiştir.

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Multicenter International Survey on the Clinical Practice of Ultra-Fast-Track Anesthesia with On-Table Extubation in Pediatric Congenital Cardiac Surgery

Cited by 28 publications

References 25 publications

Evaluation of analgesic and sedative effects of remifentanil‐based fast‐track anesthesia in children undergoing transthoracic device closure of ventricular septal defects

Evaluation of analgesic and sedative effects of remifentanil‐based fast‐track anesthesia in children undergoing transthoracic device closure of ventricular septal defects

Fast tracking after repair of congenital heart defects

Evolution from Rapid Discharge Program to ERAS Protocols in Cardiovascular Surgery

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