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RECENT ADVANCES IN CARDIAC ANAESTHESIA |
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| Fast tracking in paediatric cardiac anaesthesia : an update. Carol L Lake July 2002, 5(2):203-8 PMID:17827614A care plan in which cardiac surgical patients progress quickly through the perioperative course to hospital discharge is often referred to as a Fast Track. Such care plans have been used extensively in adult cardiac patients but are also applicable to paediatric patients. Although no randomised controlled trials are available to document a reduction in hospital costs and avoidance of iatrogenic complications with paediatric fast tracks, many healthcare administrators encourage their use. Fast Track clinical guidelines usually include same day surgery, use of short- acting anaesthetic drugs, early extubation, effective pain management, and reduced intensive care unit stays. These protocols are certainly appropriate for simple procedures such as repair of atrial or ventricular septal defects or ligation of a patent ductus arteriosus. However, many paediatric cardiac anaesthesiologists consider that all paediatric patients without significant pulmonary or residual cardiac pathology can be managed using expedited postoperative protocols. Essential components in a "fast track" protocol include use of minimally invasive surgical techniques, modified ultrafiltration during cardiopulmonary bypass, transoesophageal echocardiography to evaluate the cardiac repair, and postoperative pain control. Using such techniques, 80-90% of paediatric patients can be extubated in the operating room or within 2-4 hours postoperatively. Despite the opinions of recognised experts, an appropriately sized and powered multicentre, controlled, randomised, prospective study is still needed to conclusively document the efficiency and effectiveness of the Fast Track in paediatric cardiac patients. |
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| Cardiac anaesthesia : current trends and future prospects. JM Manners July 2002, 5(2):115-8 PMID:17827600 |
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RECENT ADVANCES IN CARDIAC ANAESTHESIA |
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| Physiology of pulmonary circulation and its relevance to the cardiac anaesthetist. Ala S Haddadin, D Nyhan July 2002, 5(2):209-19 PMID:17827615 |
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| Recent advances in paediatric cardiac anaesthesia. Achal Kumar Dhir, S Dhir July 2002, 5(2):192-202 PMID:17827613 |
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| Risk Assessment and Outcome after CABG. V Gupta, V Grover July 2002, 5(2):156-8 PMID:17827606 |
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| Current trends in the postoperative ventilatory management of patients undergoing cardiac surgery. Paul S Myles, V Pelligrino July 2002, 5(2):172-5 PMID:17827610 |
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| Advances in noninvasive cardiac output monitoring. David M Linton, D Gilon July 2002, 5(2):141-8 PMID:17827604 |
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| Fluid management during pulmonary resection surgery. P Slinger July 2002, 5(2):220-4 PMID:17827616 |
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| Recent advances in paediatric cardiac surgery. Ashwini Kumar Pawade July 2002, 5(2):183-91 PMID:17827612 |
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| TEE as an Intraoperative Haemodynamic Monitoring Tool. Jan It Poelaert July 2002, 5(2):119-26 PMID:17827601 |
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| Influence of different colloid solutions on coagulation status in patients undergoing cardiac surgery. J Boldt July 2002, 5(2):166-71 PMID:17827609 |
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| Monitoring awareness during cardiac surgery. A Fiehn July 2002, 5(2):149-55 PMID:17827605 |
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| Postoperative Pain Relief in Adult Cardiac Surgical Patients via Intrathecal and Epidural Techniques. Mark A Chaney July 2002, 5(2):176-82 PMID:17827611 |
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| Intraoperative assessment of the mitral valve by transoesophageal echocardiography : an overview. R Kodavatiganti July 2002, 5(2):127-34 PMID:17827602 |
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| Perioperative transoesophageal echocardiography : certification, training and credentialings. S Aronson July 2002, 5(2):135-40 PMID:17827603 |
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| Optimal management of cardiopulmonary bypass for the high risk patient. John M Murkin July 2002, 5(2):162-5 PMID:17827608 |
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| Organ dysfunction following off-pump coronary artery bypass surgery. R Juneja July 2002, 5(2):159-61 PMID:17827607 |
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