FAST TRACK CARDIAC SURGERY

Abstract

Objective: The aim of this study was to determine the applicability of fast trackprotocol for cardiac surgery in our unit .

Methodology: This cross sectional study was conducted at Civil HospitalDUMHS, Karachi from 1 February to 30 August 2014. Study population wasfollowed for 120 hours after surgery. Our primary endpoint was to achieve patientdischarge within 72 hours. While secondary endpoint was to observe limitationsof fast track protocol and readmission rate in patients discharge within 72 hours.

Results: A total of 85 patients underwent different open and close heartsurgeries. Fast track protocol was successfully observed in 37(44%) patientswhile remaining patients follows for 120 h. A significant association of failed fasttrack approached was observed in patients with DM 16(73%)(RR 1.18 ,OR 1.86)and smoking 9(74%)(RR 1.23,OR 2.14) and poor left ventricular function(RR1.16,OR 1.66) with readmission rate of 6(17%), for following reasons delayedtamponade (1), SSI (4), respiratory insufficiency (1).

Conclusion: With the limited resources successful discharge in 44% patients,we believe our fast-track management, is applicable for safe postoperativemanagement of patients undergoing cardiac surgery. Major contributing factorsfor failure of fast track protocol were identified by this study. These factors need tobe targeted accordingly by modifications in our postoperative management .