Fast Track Cardiac Surgery Pathways

作者：Davy Cheng · 发表于：Anesthesiology · 年份：1998 · DOI：10.1097/00000542-199806000-00002 · 被引用次数：163 · 研究领域：Cardiac, Anesthesia and Surgical Outcomes、Anesthesia and Sedative Agents、Hemodynamic Monitoring and Therapy

Associate Professor of Anesthesia; University of Toronto; Deputy Anesthetist-in Chief and Director; Cardiac Anesthesia and Intensive Care; The Toronto Hospital; Toronto, Ontario, Canada;davycheng@compuserve.comAccepted for publication April 2, 1998.This Editorial View accompanies the following articles: Butterworth J, James R, Prielipp RC, Cerese J, Livingston J, Burnett DA, and the CABG Clinical Benchmarking Data Base Participants: Do shorter-acting neuromuscular blocking drugs or opioids associate with reduced intensive care unit or hospital length of stay after coronary artery bypass grafting? Anesthesiology 1998; 88:1437–46; and London MJ, Shroyer AL, Coll JR, MaWhinney S, Fullerton DA, Hammermeister KE, Grover FL: Early extubation following cardiac surgery in a veterans population. Anesthesiology 1998; 88:1447–58.COST containment and efficient resource use have forced the pendulum back to the debate of early tracheal extubation in cardiac surgical patients and the evolution of value-based anesthesia care. [1,2]The pressure to reduce costs resulted from market forces and health care reform in the 1990s. In this era of cost containment and physician report cards, we are held accountable for patients' outcome in terms of mortality, morbidity, quality of life, length of stay (LOS), and costs of care. Although it has recently been demonstrated that early tracheal extubation anesthesia is safe, cost beneficial, and can improve resource use in cardiac surgery, [3,4]questions st...