HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Robert L. Quigley Felice L. Reitknecht Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Quigley, R. L. Articles by Reitknecht, F. L. Search for Related Content PubMed PubMed Citation Articles by Quigley, R. L. Articles by Reitknecht, F. L.

Ann Thorac Surg 1997;64:706-709
© 1997 The Society of Thoracic Surgeons

---

Original Article: Cardiovascular

A Coronary Artery Bypass "Fast-Track" Protocol Is Practical and Realistic in a Rural Environment

Cardiothoracic Section, Department of Surgery, Guthrie Clinic, Sayre, Pennsylvania

Accepted for publication March 28, 1997.

Background. In this study we determine retrospectively whether assignment of all patients undergoing coronary artery bypass grafting to a "fast-track" protocol (FT) is practical and realistic in our rural institution.

Methods. We compared the outcome of 266 consecutive patients undergoing coronary artery bypass grafting who were fast-tracked in 1996 with that of 266 consecutive patients who were managed conventionally (NFT) in 1994. The surgical techniques were comparable in both groups; however, FT anesthesia used inhalational agents and short-acting narcotics. All comparisons were performed using the Student's t test or the ² test.

Results. Postoperatively 95% of the FT group were extubated by 24 hours compared with 0% in the NFT group (p< 0.0001). The mean intensive care unit length of stay in the FT group was 1.7 ± 0.8 days, whereas it was 2.6 ± 0.6 days in the NFT group (p< 0.001). The mean postoperative length of stay was 6.4 ± 1.2 days in the FT group compared with 7.5 ± 0.9 days in the NFT group (p< 0.001). There were no significant differences in 30-day morbidity/mortality. There was a substantial cost savings in the FT group.

Conclusions. The fast-track protocol can be successful without any compromise of patient care. Early discharge from the hospital, however, is not always feasible.

This article has been cited by other articles:

				J. Gooi, S. Marasco, M. Rowland, D. Esmore, J. Negri, and A. Pick Fast-Track Cardiac Surgery: Application in an Australian Setting Asian Cardiovascular and Thoracic Annals, April 1, 2007; 15(2): 139 - 143. [Abstract] [Full Text] [PDF]

				U. Guller, K. J. Anstrom, W. L. Holman, R. M. Allman, M. Sansom, and E. D. Peterson Outcomes of early extubation after bypass surgery in the elderly Ann. Thorac. Surg., March 1, 2004; 77(3): 781 - 788. [Abstract] [Full Text] [PDF]

				M. Flynn, S. Reddy, W. Shepherd, C. Holmes, D. Armstrong, C. Lunn, K. Khan, and S. Kendall Fast-tracking revisited: routine cardiac surgical patients need minimal intensive care Eur J Cardiothorac Surg, January 1, 2004; 25(1): 116 - 122. [Abstract] [Full Text] [PDF]

				H. L. Lazar, C. A. Fitzgerald, T. Ahmad, Y. Bao, T. Colton, O. M. Shapira, and R. J. Shemin Early discharge after coronary artery bypass graft surgery: Are patients really going home earlier? J. Thorac. Cardiovasc. Surg., May 1, 2001; 121(5): 943 - 950. [Abstract] [Full Text] [PDF]

				E. Ovrum, G. Tangen, C. Schiott, and S. Dragsund Rapid recovery protocol applied to 5,658 consecutive "on-pump" coronary bypass patients Ann. Thorac. Surg., December 1, 2000; 70(6): 2008 - 2012. [Abstract] [Full Text] [PDF]