Ventilation time and LOS in ICU and thus fast-track potential is not affected by low or moderate sufentanil administration - a randomized study

2016 ◽  
Vol 30 ◽  
pp. S45
Author(s):  
Niels Eykens Hjørnet ◽  
PK Ryhammer ◽  
R. Bhavsar ◽  
C.-J. Jakobsen
Keyword(s):  
Fast Track ◽  
Randomized Study ◽  
Ventilation Time

THE FEASIBILITY OF FAST TRACK PROTOCOL FOR ELDERELY PATIENTS WITH COLORECTAL CANCER

2016 ◽  
pp. 26-29
Author(s):  
D. . Zitta ◽  
V. . Subbotin ◽  
Y. . Busirev
Keyword(s):  
Colorectal Cancer ◽  
Colorectal Surgery ◽  
Blood Loss ◽  
Elderly Patients ◽  
Fast Track ◽  
Randomized Study ◽  
Conventional Group ◽  
Intraoperative Blood Loss ◽  
Elective Colorectal Surgery ◽  
Complications Rate

Fast track protocol is widely used in major colorectal surgery. It decreases operative stress, shortens hospital stay and reduces complications rate. However feasibility and safety of this approach is still controversial in patients older than 70 years. The AIM of the study was to estimate the safety and effectiveness of fast track protocol in elderly patients with colorectal cancer. MATERIALS AND METHODS. Prospective randomized study included 138 elective colorectal resectionfor cancer during period from 1.01.10 till 1.06.15. The main criteria for the patients selection were age over 70 years and diagnosis of colorectal cancer. 82 of these patients received perioperative treatment according to fast track protocol, other 56 had conventional perioperative care. Patients underwent following procedures: right hemicolectomy (n=7), left hemicolectomy (n=12), transverse colectomy (n=1), sigmoidectomy (n=23), abdomeno-perineal excision (n=19) and low anterior resection of rectum (n=76). Following data were analized: duration of operation, intraoperative blood loss, time offirst flatus and defecation, complications rates. RESULTS. Mean age was 77,4 ± 8 years. There were no differences in gender, co morbidities, body mass index, types of operations between groups. Duration of operations didn't differ significantly between 2 groups. Intraoperative blood loss was higher in conventional group. The time of first flatus and defecation were better in FT-group. There was no mortality in FT-group vs 1,8 %o mortality in conventional group. Complications rate was lower in FT-group: wound infections 3,6% vs 9 %, anastomotic leakage 4,8 %o vs 9 %o, ileus 1,2 vs 5,4 %o, peritonitis 2,4 %o vs 3,6%o, bowel obstruction caused by the adhesions 6 % vs 5,3 %. Reoperation rate was similar 4,8 % vs 3,6 %. CONCLUSION. Fast track protocol in major elective colorectal surgery can be safely applied in elderly patients. The application of fast track protocol in elderly patients improves the restoration of bowel function and reduces the risk of postoperative complication.

Early tracheostomy decreases ventilation time but has no impact on mortality of intensive care patients: a randomized study

2012 ◽  
Vol 397 (6) ◽  
pp. 1001-1008 ◽  
Author(s):  
Tillo Koch ◽  
Birgit Hecker ◽  
Andreas Hecker ◽  
Florian Brenck ◽  
Matthias Preuß ◽  
...  
Keyword(s):  
Intensive Care ◽  
Randomized Study ◽  
Early Tracheostomy ◽  
Ventilation Time ◽  
Intensive Care Patients

Fast-track in open intestinal surgery: Prospective randomized study (Clinical Trials Gov Identifier no. NCT00123456)

2009 ◽  
Vol 28 (6) ◽  
pp. 618-624 ◽  
Author(s):  
Zuzana Šerclová ◽  
Petr Dytrych ◽  
Jaroslav Marvan ◽  
Kateřina Nová ◽  
Zuzana Hankeová ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Fast Track ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Intestinal Surgery

Comparison of Remifentanil and Low-Dose Fentanyl for Fast-Track Cardiac Anesthesia: A Prospective Randomized Study

2013 ◽  
Vol 16 (6) ◽  
pp. 324 ◽  
Author(s):  
Boris Khanykin ◽  
Rizwan Siddiqi ◽  
Per F. Jensen ◽  
Dennis R. Bigler ◽  
Gennady V. Atroshchenko
Keyword(s):  
Cardiac Index ◽  
Fast Track ◽  
Low Dose ◽  
Myocardial Function ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Cardiac Anesthesia ◽  
Fast Tracking ◽  
Cerebral Complications ◽  
Extubation Time

<p><b>Background:</b> Different anesthetic techniques have been used for fast tracking in cardiac anesthesia. Remifentanil, with its unique pharmacokinetic profile, could be an ideal drug for fast tracking. Possible limitations of remifentanil are rapid onset of postoperative pain after discontinuation of the drug infusion, which may increase the risk of an ischemic event. We conducted this randomized study to compare the efficacy of remifentanil versus low doses of fentanyl in fast-track cardiac anesthesia. It has been hypothesized that remifentanil would provide a safe anesthesia with no impact on myocardial function and with positive effects on extubation time and mobilization.</p><p><b>Methods:</b> We compared the postoperative course of patients, the remifentanil group (RG) and the low-dose fentanyl group (LDFG), in whom remifentanil and low-dose fentanyl, respectively, were used for fast-track cardiac anesthesia. The study was designed as a prospective randomized study. The primary outcomes were changes in the cardiac index and creatine kinase MB fraction (CKMB), extubation times, mobilization times, and lengths of stay in the intensive care unit (ICU) and the hospital. Frequency of myocardial infarction (MI), reoperations due to excessive bleeding, renal impairment, and cerebral complications were registered as well.</p><p><b>Results:</b> Seventy-one patients were enrolled in the study, and 7 were excluded due to difficult airway, bleeding, and technical difficulties. The RG comprised 33 patients and the LDFG comprised of 31 patients. There were no differences between the groups in terms of age, Euroscore, types of surgery, extracorporeal circulation, and aortic cross-clamp time. We did not find significant difference in cardiac index, CKMB, extubation times, mobilization times, length of stay in the ICU and in the hospital between the groups. Postoperative complications such as MI, rates of reoperations, renal and cerebral complications and incidence of atrial fibrillation did not show any significant differences.</p><p><b>Conclusions:</b> Remifentanil fast-track anesthesia for cardiac patients has no negative impact on myocardial function. Both remifentanil and low-dose fentanyl are equally effective and safe for fast-track cardiac anesthesia. The study did not highlight any statistical superiority of remifentanil anesthesia over low-dose fentanyl anesthesia.</p>

Remifentanil Compared With Sufentanil Does Not Enhance Fast-Track Possibilities in Cardiac Surgery—A Randomized Study

2016 ◽  
Vol 30 (5) ◽  
pp. 1212-1220 ◽  
Author(s):  
Rajesh Bhavsar ◽  
Pia Katerina Ryhammer ◽  
Jacob Greisen ◽  
Linda A. Rasmussen ◽  
Carl-Johan Jakobsen
Keyword(s):  
Cardiac Surgery ◽  
Fast Track ◽  
Randomized Study

scholarly journals Postoperative Changes in Pulmonary Function after Valve Surgery: Oxygenation Index Early after Cardiopulmonary Is a Predictor of Postoperative Course

2021 ◽  
Vol 10 (15) ◽  
pp. 3262
Author(s):  
Tomohiro Murata ◽  
Motohiro Maeda ◽  
Ryosuke Amitani ◽  
Atsushi Hiromoto ◽  
Makoto Shirakawa ◽  
...  
Keyword(s):  
Fast Track ◽  
Oxygenation Index ◽  
Valve Surgery ◽  
Blood Gas ◽  
Cardiac Anesthesia ◽  
Functional Changes ◽  
Ventilation Time ◽  
Postoperative Changes ◽  
Hospital Stays ◽  
Blood Gas Analyses

Objective: To determine pulmonary functional changes that predict early clinical outcomes in valve surgery requiring long cardiopulmonary bypass (CPB). Methods: This retrospective study included 225 consecutive non-emergency valve surgeries with fast-track cardiac anesthesia between January 2014 and March 2020. Blood gas analyses before and 0, 2, 4, 8, and 14 h after CPB were investigated. Results: Median age and EuroSCORE II were 71.0 years (25–75 percentile: 59.5–77.0) and 2.46 (1.44–5.01). Patients underwent 96 aortic, 106 mitral, and 23 combined valve surgeries. The median CPB time was 151 min (122–193). PaO2/FiO2 and AaDO2/PaO2 significantly deteriorated two hours, but not immediately, after CPB (both p < 0.0001). Decreased PaO2/FiO2 and AaDO2/PaO2 were correlated with ventilation time (r2 = 0.318 and 0.435) and intensive care unit (ICU) (r2 = 0.172 and 0.267) and hospital stays (r2 = 0.164 and 0.209). Early and delayed extubations (<6 and >24 h) were predicted by PaO2/FiO2 (377.2 and 213.1) and AaDO2/PaO2 (0.683 and 1.680), measured two hours after CPB with acceptable sensitivity and specificity (0.700–0.911 and 0.677–0.859). Conclusions: PaO2/FiO2 and AaDO2/PaO2 two hours after CPB were correlated with ventilation time and lengths of ICU and hospital stays. These parameters suitably predicted early and delayed extubations.

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