To do that, the seven cardiac anesthesiologists agreed to use shorter-acting medications in the operating room. We changed our follow-up management in the ICU so patients are not kept sedated. We allow them to wake up and we wean them off the respirator as early as possible. Clinical pathways are not cookbook medicine, says cardiothoracic surgeon Joe Craver. They are guidelines that are helping patients such as Richard Johnson get out of the hospital earlier and back to their daily routines.
Patients are delighted to get off the ventilator sooner.
Patients have told us for years that what bothers them the most about open heart surgery is the breathing tube in their throat and the chest tubes for drainage. The changes have proven positive psychologically as well. It's been much better for the patient and family for the patient to be awake and talking within a few hours of surgery than to be in a sedated state with a ventilator overnight. Changing drug therapy has had other benefits, adds pharmacist Linda Pine. Antibiotics are now given immediately before surgery and for 24 hours after, rather than for three days as in the past - with no increase in infection rates and fewer fungal infections, especially in women.