DETERMINANTS OF ICU STAY IN FAST TRACK RECOVERY

TORAMAN Fevzi, KARABULUT Eşref Hasan, ALHAN Cem

Acıbadem Hastanesi, Kalp ve Damar Cerrahisi Departmanı / İSTANBUL

Fast track recovery protocol aims to decrease the time of hospitalization by early extubation and shortening the period of intensive care unit stay. In the early 1990 s it was used in selected cases to decrease cost, however, further studies showed the possibility of its wider use. The main principle of the fast-track protocol is to decrease the cost and increase the patient comfort without compromising the scecurity. The aim of this study was to identify the predictors of increased intensive care unit stay.

Between february 1999 and september 2000 625 consecutive patients undergoing open heart surgery were entered into the study. Logistic regression analysis showed that postoperative pulmonary complications (p=0.03), blood usage (p=0.05) and the use of intra aortic balloon pump (p=0.02) increase ICU stay.

We speculate that pulmonary complications, particularly the nosocomial infections, will decrease by early extubation. Precise surgery and effective cardiopulmonary bypass management strategies will decrease the blood and intra aortic balloon pump usage, thus leading to the shortening of ICU stay.

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