Fast Track and Ultra-Fast Track Cardiac Surgery Recovery Care

Abstract

‘Fast-track’ cardiac anesthesia (FTCA) is a multi-component intervention during and after cardiac surgery with the goal of early extubation. Early extubation aims to reduce the duration of mechanical ventilation, ICU length of stay, postoperative recovery, and overall resource utilization. To realize these benefits without increasing the risk of adverse events such as hemodynamic instability, respiratory distress, reintubation, and readmission requires a coordinated, multi-component approach, including focused perioperative pathways and alternative recovery models. As cardiac interventions continue to evolve with new minimally invasive approaches, procedures, and techniques, as well as the use of sedation instead of general anesthesia for certain techniques, ultra-fast track approaches are becoming more feasible for certain patient populations. This includes ultra-fast track extubation as well as an ultra-fast track recovery model in robotic hybrid CABG, TAVI, regional anesthesia, and off-pump CABG surgery, are further discussed in Chaps. 5, 7, 27, 35 of this textbook.