Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast Episode 290: Post-op Cardiac Surgery Care with Mike Grant
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Sep 8, 2024 Dr. Mike Grant returns to discuss post-operative care in cardiac surgery. He dives into the shift towards earlier extubation and advanced sedation techniques that boost recovery. The conversation highlights the declining role of pulmonary artery catheters in low-risk patients and critiques traditional monitoring practices. Grant also addresses the debate over fluid management, advocating for cost-effective crystalloid solutions. Lastly, he emphasizes the importance of patient-centered protocols for device management, paving the way for improved recovery outcomes.
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Post-Op Milestones Define Recovery
- Post-op cardiac surgery ICU care focuses on milestones like breathing tube removal and vasopressor discontinuation.
- Achieving independence in daily activities is a critical recovery milestone beyond ICU stay.
Early Extubation as New Standard
- Early extubation within 6 hours of ICU arrival is a new quality benchmark after cardiac surgery.
- Some patients can be extubated immediately after surgery, skipping prolonged ventilation.
Protocolize Intraoperative Extubation
- Extubate intraoperatively only in suitable low-risk, uncomplicated patients.
- Sustain an aggressive extubation protocol targeting 40% early extubation to reduce complications.