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Fast Track in der Herzchirurgie

Fast track in cardiac surgery

Zusammenfassung

„Fast Track“ ist in der Herzchirurgie ein noch nicht genau definierter Begriff. In der Vergangenheit wurde der Extubationszeitpunkt eines Patienten gern als Marker angegeben. Dieser Parameter allein reicht jedoch nicht aus. Neben der kardiorespiratorischen Stabilität ist zusätzlich auch die des Kreislaufs und der Hämostase zu fordern. Somit wird das Konzept in der Herzchirurgie so definiert, dass nach einer postoperativen intensiven Überwachungsphase keine weitere intensivmedizinische Behandlung erforderlich wird. Moderne chirurgische Verfahren in Verbindung mit entsprechender Narkoseführung werden in Zukunft zu einer Ausweitung des Fast-Track-Konzepts in der Herzchirurgie führen.

Abstract

Fast track in cardiac surgery is not well defined. In the past early or immediate extubation was used as a marker. After cardiac surgery this parameter is not sufficient. In addition to cardiorespiratory stability, circulatory and haemostatic homeostasis are also required. Therefore the current Fast Track concept includes a period of intensive monitoring of the patient postoperatively to establish stability. Thereafter intensive care medicine should not be required. Evolving new surgical concepts in combination with appropriate anaesthesiologic management will lead to wide application of fast track cardiac surgery in the future.

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Correspondence to M. Strüber.

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Strüber, M., Winterhalter, M. Fast Track in der Herzchirurgie. Chirurg 80, 724–729 (2009). https://doi.org/10.1007/s00104-009-1681-4

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Schlüsselwörter

  • Minimal-invasive, direkte koronare Bypassoperation
  • OPCAB
  • Extrakorporale Zirkulation
  • Hybridverfahren

Keywords

  • MIDCAB
  • Off pump coronary artery bypass
  • Extracorporeal circulation
  • Hybrid procedure