Fast-track cardiac anaesthesia protocols: Is quality pushed to the edge?

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Standard

Fast-track cardiac anaesthesia protocols : Is quality pushed to the edge? / Bhavsar, Rajesh; Ryhammer, Pia K.; Greisen, Jacob; Jakobsen, Carl Johan.

In: Annals of Cardiac Anaesthesia, Vol. 23, No. 2, 2020, p. 142-148.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Harvard

Bhavsar, R, Ryhammer, PK, Greisen, J & Jakobsen, CJ 2020, 'Fast-track cardiac anaesthesia protocols: Is quality pushed to the edge?', Annals of Cardiac Anaesthesia, vol. 23, no. 2, pp. 142-148. https://doi.org/10.4103/aca.ACA_204_18

APA

Bhavsar, R., Ryhammer, P. K., Greisen, J., & Jakobsen, C. J. (2020). Fast-track cardiac anaesthesia protocols: Is quality pushed to the edge? Annals of Cardiac Anaesthesia, 23(2), 142-148. https://doi.org/10.4103/aca.ACA_204_18

CBE

Bhavsar R, Ryhammer PK, Greisen J, Jakobsen CJ. 2020. Fast-track cardiac anaesthesia protocols: Is quality pushed to the edge?. Annals of Cardiac Anaesthesia. 23(2):142-148. https://doi.org/10.4103/aca.ACA_204_18

MLA

Bhavsar, Rajesh et al. "Fast-track cardiac anaesthesia protocols: Is quality pushed to the edge?". Annals of Cardiac Anaesthesia. 2020, 23(2). 142-148. https://doi.org/10.4103/aca.ACA_204_18

Vancouver

Bhavsar R, Ryhammer PK, Greisen J, Jakobsen CJ. Fast-track cardiac anaesthesia protocols: Is quality pushed to the edge? Annals of Cardiac Anaesthesia. 2020;23(2):142-148. https://doi.org/10.4103/aca.ACA_204_18

Author

Bhavsar, Rajesh ; Ryhammer, Pia K. ; Greisen, Jacob ; Jakobsen, Carl Johan. / Fast-track cardiac anaesthesia protocols : Is quality pushed to the edge?. In: Annals of Cardiac Anaesthesia. 2020 ; Vol. 23, No. 2. pp. 142-148.

Bibtex

@article{d4cb312ff6d24d8e830aec7fa71e4b8c,
title = "Fast-track cardiac anaesthesia protocols: Is quality pushed to the edge?",
abstract = "Background: The quest for methods expediting rapid postoperative patient turnover has triggered implementation of various fast-track cardiac anaesthesia protocols. Using three different fast-track protocols in randomized controlled studies (RCT) conducted 2010-2016 we found minimal achievements in ventilation time together with actual and eligible length of stay in cardiac recovery unit. The comparable control group patients were evaluated in this retrospective post hoc analysis, for an association between above mentioned parameters and quality parameters, to assess whether the marginal gains have been at the expense of quality of recovery and patient comfort. Method: 90 control patients from three RCT with comparable demographic parameters and receiving standard department treatment were evaluated using time parameters and an objective/semi-objective Intensive Care Unit (ICU) score system (IDS score). Results: Ventilation time was statistical significant lower in latest study (C) than the early (A) and intermedium (B) studies (A=293, B=261, C=205 minutes; P=0.04). The IDS was lower at extubation and all time points in the early study compared to other studies (P < 0.001;). The average IDS in latest study were the double of previous studies at the end of observations, and marginally above the acceptable score for discharge. The postoperative morphine requirement A=15.0, B=10.0 and C=26.5 mg; P=0.002) was statistical significant higher in the latest study compared to previous studies. Conclusion: The implementation of strict fast-track protocols resulting in shorter ventilation time did not convert to earlier eligibility to discharge from the ICU. However, the quality of recovery appears challenged.",
keywords = "Cardiac anesthesia, fast-track protocols, quality of recovery, ventilation time",
author = "Rajesh Bhavsar and Ryhammer, {Pia K.} and Jacob Greisen and Jakobsen, {Carl Johan}",
year = "2020",
doi = "10.4103/aca.ACA_204_18",
language = "English",
volume = "23",
pages = "142--148",
journal = "Annals of Cardiac Anaesthesia",
issn = "0971-9784",
publisher = "Medknow Publications and Media Pvt. Ltd",
number = "2",

}

RIS

TY - JOUR

T1 - Fast-track cardiac anaesthesia protocols

T2 - Is quality pushed to the edge?

AU - Bhavsar, Rajesh

AU - Ryhammer, Pia K.

AU - Greisen, Jacob

AU - Jakobsen, Carl Johan

PY - 2020

Y1 - 2020

N2 - Background: The quest for methods expediting rapid postoperative patient turnover has triggered implementation of various fast-track cardiac anaesthesia protocols. Using three different fast-track protocols in randomized controlled studies (RCT) conducted 2010-2016 we found minimal achievements in ventilation time together with actual and eligible length of stay in cardiac recovery unit. The comparable control group patients were evaluated in this retrospective post hoc analysis, for an association between above mentioned parameters and quality parameters, to assess whether the marginal gains have been at the expense of quality of recovery and patient comfort. Method: 90 control patients from three RCT with comparable demographic parameters and receiving standard department treatment were evaluated using time parameters and an objective/semi-objective Intensive Care Unit (ICU) score system (IDS score). Results: Ventilation time was statistical significant lower in latest study (C) than the early (A) and intermedium (B) studies (A=293, B=261, C=205 minutes; P=0.04). The IDS was lower at extubation and all time points in the early study compared to other studies (P < 0.001;). The average IDS in latest study were the double of previous studies at the end of observations, and marginally above the acceptable score for discharge. The postoperative morphine requirement A=15.0, B=10.0 and C=26.5 mg; P=0.002) was statistical significant higher in the latest study compared to previous studies. Conclusion: The implementation of strict fast-track protocols resulting in shorter ventilation time did not convert to earlier eligibility to discharge from the ICU. However, the quality of recovery appears challenged.

AB - Background: The quest for methods expediting rapid postoperative patient turnover has triggered implementation of various fast-track cardiac anaesthesia protocols. Using three different fast-track protocols in randomized controlled studies (RCT) conducted 2010-2016 we found minimal achievements in ventilation time together with actual and eligible length of stay in cardiac recovery unit. The comparable control group patients were evaluated in this retrospective post hoc analysis, for an association between above mentioned parameters and quality parameters, to assess whether the marginal gains have been at the expense of quality of recovery and patient comfort. Method: 90 control patients from three RCT with comparable demographic parameters and receiving standard department treatment were evaluated using time parameters and an objective/semi-objective Intensive Care Unit (ICU) score system (IDS score). Results: Ventilation time was statistical significant lower in latest study (C) than the early (A) and intermedium (B) studies (A=293, B=261, C=205 minutes; P=0.04). The IDS was lower at extubation and all time points in the early study compared to other studies (P < 0.001;). The average IDS in latest study were the double of previous studies at the end of observations, and marginally above the acceptable score for discharge. The postoperative morphine requirement A=15.0, B=10.0 and C=26.5 mg; P=0.002) was statistical significant higher in the latest study compared to previous studies. Conclusion: The implementation of strict fast-track protocols resulting in shorter ventilation time did not convert to earlier eligibility to discharge from the ICU. However, the quality of recovery appears challenged.

KW - Cardiac anesthesia

KW - fast-track protocols

KW - quality of recovery

KW - ventilation time

UR - http://www.scopus.com/inward/record.url?scp=85083254277&partnerID=8YFLogxK

U2 - 10.4103/aca.ACA_204_18

DO - 10.4103/aca.ACA_204_18

M3 - Journal article

C2 - 32275026

AN - SCOPUS:85083254277

VL - 23

SP - 142

EP - 148

JO - Annals of Cardiac Anaesthesia

JF - Annals of Cardiac Anaesthesia

SN - 0971-9784

IS - 2

ER -