Fasttrack approach

In recent years it has become apparent that many 'routine' patients can be extubated early. The use of short-acting anesthetic drugs combined with moderate-dose opiate regimens allows early return of consciousness and spontaneous respiration without obviously compromising patient safety. In addition, the tendency to employ less profound hypothermia for myocardial preservation, and the use of active warming and vasodilators during rewarming, imposes less metabolic stress than previous approaches. Many patients can be extubated within 4 h of surgery and, in some units, in the operating room. Dedicated postcardiac surgery recovery areas, employing the fast-track approach, can provide an efficient service without dependence on the availability of intensive care beds ( Chong.etal 1992).

The key to a successful fast-track program is proper patient selection, high-level supervision by a disciplined team, and absence of surgical complications.

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Sleep Apnea

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