Iqbal Hussain, Raffat Tanveer, Mudasir Iqbal Dar.
Fast track cardiac surgery.
Pak Heart J Jan ;48(1):36-41.

Objective: The aim of this study was to determine the applicability of fast track protocol for cardiac surgery in our unit . Methodology: This cross sectional study was conducted at Civil Hospital DUMHS, Karachi from 1 February to 30 August 2014. Study population was followed for 120 hours after surgery. Our primary endpoint was to achieve patient discharge within 72 hours. While secondary endpoint was to observe limitations of fast track protocol and readmission rate in patients discharge within 72 hours. Results : A total of 85 patients underwent different open and close heart surgeries. Fast track protocol was successfully observed in 37(44%) patients while remaining patients follows for 120 h. A significant association of failed fast track approached was observed in patients with DM 16(73%)(RR 1.18 ,OR 1.86)and smoking 9(74%)(RR 1.23,OR 2.14) and poor left ventricular function(RR1.16, OR 1.66) with readmission rate of 6(17%), for following reasons delayed tamponade (1), SSI (4), respiratory insufficiency (1). Conclusion: With the limited resources successful discharge in 44% patients,we believe our fast-track management, is applicable for safe postoperative management of patients undergoing cardiac surgery. Major contributing factors for failure of fast track protocol were identified by this study. These factors need to be targeted accordingly by modifications in our postoperative management .

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