Rapid recovery protocol applied to 5,658 consecutive “on-pump” coronary bypass patients

Øvrum, Eivind; Tangen, Geir; Schiøtt, Carla; Dragsund, S

doi:10.1016/s0003-4975(00)01849-x

Cited by 27 publications

(17 citation statements)

References 22 publications

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“…The position of the pedometer was over the right or left ASIS attached to the patient's garment and it was checked twice a day when the number of steps was recorded. All pedometers used were checked before and after each patient wore them to detect AE2 steps error on the 20 Step Test [8].…”

Section: Methodsmentioning

confidence: 99%

“…For these reasons the concept of reducing hospital stays with concomitant reduction in hospital cost is very attractive. Rapid recovery protocols have been shown to be safe, cost effective and associated with accelerated and uneventful long-term recovery [18][19][20][21]. Early and active ambulation constitutes an integral part of rapid recovery protocols as it has been shown to contribute to improved functional capacity, decreased deconditioning related to bed rest, decreased emotional problems such as depression and anxiety [15] and even improve wound healing [22,23].…”

Section: Inactivity Costsmentioning

confidence: 99%

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Analysis of bedside entertainment services’ effect on post cardiac surgery physical activity: a prospective, randomised clinical trial

Papaspyros

Uppal

Khan

et al. 2008

European Journal of Cardio-Thoracic Surgery

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Section: Methodsmentioning

confidence: 99%

Section: Inactivity Costsmentioning

confidence: 99%

Analysis of bedside entertainment services’ effect on post cardiac surgery physical activity: a prospective, randomised clinical trial

Papaspyros

Uppal

Khan

et al. 2008

European Journal of Cardio-Thoracic Surgery

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“…One possibility is the optimised use of available intensive care capacities by having several patients on one hospital bed daily. This requires efficient surgical planning, as well as a meticulous preoperative assessment of the patient population [1-4,13-22]. Besides shortening ICU occupancy times, which is undisputedly the limiting factor and the bottleneck in the care of heart surgery patients, the rising costs can be contained by shortening the overall hospitalisation period [16,19,20].…”

Section: Introductionmentioning

confidence: 99%

Risk factor analysis for fast track protocol failure

Kiessling

Huneke

Reyher

et al. 2013

J Cardiothorac Surg

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BackgroundThe introduction of fast-track treatment procedures following cardiac surgery has significantly shortened hospitalisation times in intensive care units (ICU). Readmission to intensive care units is generally considered a negative quality criterion. The aim of this retrospective study is to statistically analyse risk factors and predictors for re-admission to the ICU after a fast-track patient management program.Methods229 operated patients (67 ± 11 years, 75% male, BMI 27 ± 3, 6/2010-5/2011) with use of extracorporeal circulation (70 ± 31 min aortic crossclamping, CABG 62%) were selected for a preoperative fast-track procedure (transfer on the day of surgery to an intermediate care (IMC) unit, stable circulatory conditions, extubated). A uni- and multivariate analysis were performed to identify independent predictors for re-admission to the ICU.ResultsOver the 11-month study period, 36% of all preoperatively declared fast-track patients could not be transferred to an IMC unit on the day of surgery (n = 77) or had to be readmitted to the ICU after the first postoperative day (n = 4). Readmission or ICU stay signifies a dramatic worsening of the patient outcome (mortality 0/10%, mean hospital stay 10.3 ± 2.5/16.5 ± 16.3, mean transfusion rate 1.4 ± 1,7/5.3 ± 9.1). Predicators for failure of the fast-track procedure are a preoperative ASA class > 3, NYHA class > III and an operation time >267 min ± 74. The significant risk factors for a major postoperative event (= low cardiac output and/or mortality and/or renal failure and/or re-thoracotomy and/or septic shock and/or wound healing disturbances and/or stroke) are a poor EF (OR 2.7 CI 95% 0.98-7.6) and the described ICU readmission (OR 0.14 CI95% 0.05-0.36).ConclusionRe-admission to the ICU or failure to transfer patients to the IMC is associated with a high loss of patient outcome. The ASA > 3, NYHA class > 3 and operation time >267 minutes are independent predictors of fast track protocol failure.

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“…In effect, the implementation of fast recovery after surgical management allows the achievement of gait autonomy within the fifth postoperative day in more than 90% patients, 16 thus providing the possibility of an earlier transfer to rehabilitation services. Previous experiences 17 have indicated that, in selected and relatively young patients, rehabilitation may begin a week after the operation without any relevant effect on postoperative complications, mortality, or other late major adverse events.…”

mentioning

confidence: 99%

Early and Late Rehabilitation and Physical Training in Elderly Patients After Cardiac Surgery

Macchi

Fattirolli

Lova

et al. 2007

American Journal of Physical Medicine &Amp; Rehabilitation

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Rapid recovery protocol applied to 5,658 consecutive “on-pump” coronary bypass patients

Cited by 27 publications

References 22 publications

Analysis of bedside entertainment services’ effect on post cardiac surgery physical activity: a prospective, randomised clinical trial

Analysis of bedside entertainment services’ effect on post cardiac surgery physical activity: a prospective, randomised clinical trial

Risk factor analysis for fast track protocol failure

Early and Late Rehabilitation and Physical Training in Elderly Patients After Cardiac Surgery

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