Ultra-fast-tracking in cardiac anesthesia “Our Experience” in a rural setup

Taware, Manisha; Sonkusale, Manish; Deshpande, Rashmi

doi:10.4103/jdmimsu.jdmimsu_56_17

Cited by 4 publications

(3 citation statements)

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“…Extubation could be achieved within 30 min in 72.5% of patients with a mean ICU LOS of 39 h, 55% of patients wereambulated on postoperative day 1, and UFTA led to approximate cost savings of 5000 rupees/patient/day. 35 According to the experts in transplant anaesthesia, FTA in transplant surgeries in India has evolved over a period of time. ERAS criteria are usually adhered to.…”

Section: Current Practice Of Fta In Indiamentioning

confidence: 99%

Fast-track anaesthesia in cardiac and transplant surgeries- An Indian perspective

Guhabiswas¹,

Vohra

2023

IJCA

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Fast-track anaesthesia (FTA) involves early tracheal extubation after surgery, ranging from extubation on-table to within 6-8 hours postoperatively. It is associated with reduced length of intensive care and hospital stay and fewer postoperative complications, which lead to cost savings for patients and more efficient use of resources for hospitals. Despite the extensive literature on the safety and advantages of FTA in cardiac and transplant surgeries worldwide, its implementation in India is highly variable. Moreover, literature on the use of FTA in India is also scarce. Standardised protocols, appropriate selection of patients potentially suitable for FTA, and multidisciplinary collaboration are essential to ensure the wider adoption and success of FTA in India.

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Section: Current Practice Of Fta In Indiamentioning

confidence: 99%

Fast-track anaesthesia in cardiac and transplant surgeries- An Indian perspective

Guhabiswas¹,

Vohra

2023

IJCA

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“…Ultrafast tracking algorithm in cardiac anesthesia has significantly fastened the postoperative recovery. 10,11 Benefits of Fast Tracking with Use of TIVA and PLMA TIVA with LMA offers certain advantages over other techniques in terms of reduced airway and lung trauma, improved cardiac output and renal perfusion with spontaneous respiration, decreased stress and discomfort of ETT suctioning and weaning from ventilation, substantially reduced requirement of dosages of analgesics, anesthetics and opioids, resulting in better patient hemodynamics, alert and pain-free patients who are more amenable and cooperative for early feeds, postoperative chest physiotherapy and lung recruitment strategies, and early ambulation and discharge.…”

Section: Ultrafast Track Anesthetic (Ufta) Techniquementioning

confidence: 99%

Fast Tracking in Off Pump CABG with Supraglottic Airway and TIVA

Shah

2021

Journal of Cardiac Critical Care TSS

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The standard goals of anesthetic management for an off pump coronary artery bypass (OPCAB) surgery are that it should be safe, provide cardiac and other organ protection and stability, preserve neurocognitive integrity, maintain hemodynamics, allow early emergence and ambulation, and offer pain relief in the postoperative period. The cardiac surgical team should collaborate and plan the best preoperative strategy, so as to provide optimal care and a rapid and expeditious recovery of these patients. Scientific evidence and practical experience make total intravenous anesthesia (TIVA) the recommended choice for cardiac surgery. Use of endotracheal tube (ETT) is associated with certain drawbacks which can be overcome with judicious use of ProSeal laryngeal mask airway (PLMA) for cardiac surgeries too. The core principles of ultrafast track anesthetic (UFTA) technique are choice and titration of short-acting anesthetic drugs, postoperative normothermia, multimodal analgesia, early extubation, ambulation, and discharge. Fast tracking with use of TIVA and PLMA in patients undergoing OPCAB at our center offers certain advantages over other techniques in terms of reduced airway and lung trauma, improved cardiac output and renal perfusion with spontaneous respiration, decreased stress and discomfort of ETT suctioning and weaning from ventilation, substantially reduced requirement of dosages of analgesics, anesthetics and opioids, resulting in better patient hemodynamics, alert and pain-free patient that are more amenable and cooperative for early feeds, postoperative chest physiotherapy and lung recruitment strategies, and early ambulation and discharge.

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“…In these centers, it may be prudent to identify patients suitable for an FT protocol, compared with patients who would be more likely to have higher postoperative ventilatory and inotropic support requirements, as there may be significant cost savings associated with this. [10][11][12] Time of day may limit the potential for early extubation in both models, with a general reluctance to extubate patients overnight. Hwang et al demonstrated that most postoperative cardiac surgical patients admitted to an ICU were extubated between 7 AM and 8 PM, with relatively few patients extubated overnight, despite a protocol aiming for early extubation within 4 hours of arrival in the ICU.…”

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confidence: 99%