Early extubation in adult and pediatric open heart surgery; an experience from a tertiary care hospital of a developing country

ABSTRACT

Numerous remarkable advances have been made in the perioperative care of both adults and children undergoing cardiac surgery. Improvements in the technology of CPB, advances in the techniques of surgery, a better understanding of the pathophysiology of the postoperative period, and refinements in anesthetic and ICU care have led to changes in the perioperative management of these patients. These changes have resulted in improved outcomes and shortened hospital stay. Fast track strategy [FTS] is one of the major advances in the sub-specialty of cardiac anesthesia practice. FTS is applicable to all moderate to low risk elective open heart adult and pediatric surgeries. The role of anesthesiologist in Fast Track extubation [FTE] is very crucial and decisive as perioperative physician. Teamwork in FTE execution is very important. Every team member should respect the opinion of other team member provided the opinion is in the best interest of the patient. Multiple studies conducted as clinical audits and case series to validate the safety and feasibility of fast track extubation in adult and pediatric open heart surgical patients at our institution. Fast track extubation was practically evolved at our institution in 2007. FTE cannot be predicted in all the cases as it depends upon intra-operative and post-operative course. Safety is the priority in the decision about fast track extubation