Clinical trial NCT05321173: Fast-Track in Cardiac Anesthesia
Official title: Non-interventional Feasibility Assessment for Fast-Track Cardiac Anesthesia
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Cardiac Surgery
Keywords: cardiac anesthesia
fast-track
pandemic
ICU
early recovery
Lead sponsor: Ankara City Hospital Bilkent
Sponsor class: OTHER
First posted: 2022-04-11
Enrollment: 200
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Adult patients who underwent elective or emergency cardiac surgery within 2 months

Brief summary: The introduction of fast-track extubation procedures following cardiac surgery has significantly shortened hospitalization times in intensive care units. In this study, it was aimed to determine the obstacles to the early recovery of patients who underwent cardiac surgery in the crisis environment that developed with the pandemic.

Detailed description: After the time we struggled to overcome the many crises that the pandemic period brought to our lives, it has been clearly seen that the decrease in the number of nurses and doctors and the limitation of the number of beds allocated for postoperative intensive care have been mandatory attempts due to the shift of personnel to areas to fight the pandemic. The fact that cardiac surgery operations are not elective and cardiac patients cannot wait for a long time due to their existing pathologies has led physicians to strive to provide the best service with available resources. To ensure that the cardiac surgery operating room and intensive care beds of our hospital can be used more efficiently and to take initiatives to optimize the recovery in the postoperative period are among the important goals of today and the future. The reason for this is not only to reduce costs and loss of workforce but also to be ready for any crisis time. In addition, it is aimed to perform the operations of critical patients without delay and to successfully discharge them. In the postoperative period, if the functions of many basic organ systems can provide the necessary ideal conditions, the patients can be extubated within 8 hours in fast-track cardiac anesthesia (FTCA) programs. Some problems persist or occur in patients with functional problems such as hemodynamics, cardiac, and respiration who do not meet the extubation criteria. For all these reasons, a prospective, cross-sectional study was planned to focus on daily standard practices and improve areas of failure.

Accordingly, this study aimed to examine the preoperative, intraoperative, and postoperative characteristics of patients who underwent cardiac surgery, and to investigate the factors in patients who could not be extubated within 8 hours after surgery.

Eligibility criteria: Inclusion Criteria:

* All adult patients who underwent elective or emergency cardiac surgery

Exclusion Criteria:

* Patients undergoing pediatric cardiac surgeries

Primary outcomes:
measure: Extubation time
timeFrame: Postoperative period, up to 24 hours
Secondary outcomes:
Other outcomes:
Locations:
city: Ankara
country: Turkey
facility: Ankara City Hospital
state: Select State/Province
Study officials:
affiliation: Ankara City Hospital Bilkent
name: ZELİHA A DEMİR, Professor
role: PRINCIPAL_INVESTIGATOR
References:
citation: Haanschoten MC, van Straten AH, ter Woorst JF, Stepaniak PS, van der Meer AD, van Zundert AA, Soliman Hamad MA. Fast-track practice in cardiac surgery: results and predictors of outcome. Interact Cardiovasc Thorac Surg. 2012 Dec;15(6):989-94. doi: 10.1093/icvts/ivs393. Epub 2012 Sep 5.
citation: Wong WT, Lai VK, Chee YE, Lee A. Fast-track cardiac care for adult cardiac surgical patients. Cochrane Database Syst Rev. 2016 Sep 12;9(9):CD003587. doi: 10.1002/14651858.CD003587.pub3.
citation: Myles PS, Daly DJ, Djaiani G, Lee A, Cheng DC. A systematic review of the safety and effectiveness of fast-track cardiac anesthesia. Anesthesiology. 2003 Oct;99(4):982-7. doi: 10.1097/00000542-200310000-00035. No abstract available.