Implementation of a recovery room for patients undergoing cardiac surgery

Introduction: Economics and limited resources of intensive care beds has caused the trend of early extubation after cardiac surgery. To achieve this a recovery room (RR), managed by the anaesthesia team, was built up close to the operation theatre and a fast track protocol was installed. Methods: Patients undergoing elective cardiac surgery were treated according to a fast track protocol (FTP) with remifentanil. Prospectively time to extubation, length of stay (LOS) on intensive care unit (ICU), on intermediate care (IMC) and total hospital stay were evaluated. These pts. were compared retrospectively to a control group, treated according to routine protocol (RP) with sufentanil: Results: 140 pts were included in each group. No significant differences were seen regarding demographic data. Group FTP Group RP p Value Extubation time RR (n 131) 1.5h Extubation time at all (n 140) 3.5h 26.4h 0.001 LOS RR/ ICU 3.9h 40.8h 0.001 LOS IMC 30.9h 42.9h 0.04 Hospital LOS 10.5d 11.8d 0.001 9 patients in FTP-group could not be extubated in the RR and had to be discharged to ICU. Readmission rate to ICU after transfer from RR to IMC was 1 pt for the FTP-group versus 5 pts for the RP-group. Conclusion: Implementation of a fast track protocol and a recovery room is an effective tool to save costs and ICU capacity.