Current evidence is insufficient to show that multi-vessel off-pump coronary artery bypass surgery reduces morbidity and intensive care unit length of stay.
This review highlights trends in postoperative cardiac intensive care, noting insufficient evidence for off-pump CABG reducing ICU length of stay and advocating for flexible integrated unit designs.
Postoperative intensive care in cardiac surgery is a growing area, fuelled by the increase in the number of cardiac surgical procedures performed. An increase in the number of patients has resulted in increased resource utilization. Much of the recent research in this field is concerned with the early extubation of cardiac surgical patients, reducing the length of stay in the intensive care unit and predicting which patients will have delayed extubation and a prolonged length of stay. A number of recent studies have been published advocating 'off pump' cardiac surgery as a way of reducing the physiological insult of cardiopulmonary bypass and thereby improving the postoperative course. There is still insufficient evidence that this approach reduces morbidity and intensive care unit length of stay in multi-vessel off-pump coronary artery bypass surgery. The traditional design of post-cardiac surgical intensive care units and high dependency units has also recently been challenged. More flexible integrated units improve cost control and are more suited to modern cardiac surgery.
Wake et al. (2001) conducted a review in Cardiac surgery. Postoperative intensive care and off-pump cardiac surgery was evaluated. Current evidence is insufficient to show that multi-vessel off-pump coronary artery bypass surgery reduces morbidity and intensive care unit length of stay.