Ultra-fast-tracking in cardiac anesthesia “Our Experience” in a rural setup

Background: Fast-track cardiac anesthesia refers to extubation within 6 h of the end of surgery, whereas ultra-fast-track anesthesia (UFTA) refers to extubation within 2 h of the end of surgery. Objectives: We have tested a protocol for early extubation to see safety, efficacy of ultra-fast tracking, and its cost containment in the present study of forty patients in cardiac surgery department in a tertiary care rural center. Materials and Methods: We have observed in our study the outcome of UFTA on a set of forty patients posted for cardiac surgery, using a protocolized approach and have prospectively noted the duration of mechanical ventilation, extubation time, length of Intensive Care Unit (ICU) stay, rate of re intubation, and other complication. Results: Extubation could be achieved within 30 min in 29 patients (72.5%). Mean length of ICU stay could be cut to 1.6 days (39 h). 55% patients could be mobilized on postoperative day 1, With approximate cost savings of 5000 rupees/patient/day. No cases of reintubation or serious complications noted. Conclusion: Ultra-fast-tracking is found to be feasible in our cardiac surgical setup. It is safe in all age groups, with proper selection of cases and rational utilization of available resources, besides it is found to be cost-effective.