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Related Experiment Videos

Accelerated recovery after cardiac operations.

Mehmet Kaplan1, Mustafa Sinan Kut, Nurgul Yurtseven

  • 1Department of Cardiovascular Surgery, Siyami Ersek Thoracic and Cardiovascular Surgery Center, 67 Ada Kardelen 4-4, D:11 Atasehir-81120, Istanbul, Turkey. mehmetkaplan@superonline.com

The Heart Surgery Forum
|January 23, 2003
PubMed
Summary

The accelerated-recovery approach in cardiac surgery, involving early extubation and mobility, is safe and effective. This method significantly reduces intensive care unit and hospitalization durations with low complication rates.

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Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Critical Care Medicine

Background:

  • The accelerated-recovery approach in cardiac surgery, characterized by early extubation, mobility, and reduced intensive care unit (ICU) and hospital stays, is a subject of ongoing debate.
  • This approach aims to optimize patient recovery pathways following complex surgical procedures.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of an accelerated-recovery protocol in a cohort of cardiac surgery patients.
  • To assess key metrics including timing of extubation, ICU length of stay, and overall hospitalization duration.

Main Methods:

  • A prospective investigation was conducted on 225 consecutive cardiac surgery patients undergoing various procedures, including coronary artery bypass grafting and valvular operations.
  • Data collected included patient demographics, surgical procedure type, extubation time, ICU stay duration, and hospitalization length.

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  • Discharge criteria focused on hemodynamic stability, patient cooperation, mobility, laboratory results, and psychological readiness.

    • Main Results:

    • The accelerated-recovery approach was successfully applied in 75.11% (169/225) of patients.
    • Accelerated-recovery patients were extubated at an average of 3.97 hours, with an average ICU stay of 20.93 hours and a mean hospitalization of 4.24 days.
    • Complication rates were low: 1.18% required reintubation, 2.36% returned to the ICU, and 3.55% were rehospitalized.

    Conclusions:

    • The accelerated-recovery approach is applicable and safe for elective, uncomplicated cardiac surgery patients, particularly those with shorter aortic cross-clamping and cardiopulmonary bypass times.
    • This strategy effectively reduces intubation, ICU, and hospitalization durations without compromising patient safety.
    • The observed low rates of reintubation, ICU readmission, and rehospitalization support the widespread adoption of this protocol.