Strategies to Reduce Failure to Rescue after Cardiac Surgery

Failure to rescue (FTR), defined as mortality after a postoperative complication, is now a central quality metric in cardiac surgery, where high-acuity patients and resource-intensive care increase vulnerability to deterioration. Although complications are common, survival depends on timely recognition, effective escalation, and coordinated multidisciplinary management. This article synthesizes current evidence on the epidemiology, mechanisms, and system-level drivers of FTR, highlighting how patient, provider, and institutional factors influence rescue success. We outline practical, evidence-based strategies to reduce FTR in cardiac surgery after prolonged ventilation, renal failure, stroke, and reoperation, by emphasizing protocolized care, staffing models, team communication, and rapid response infrastructure.