caa a22 4500 445373504 CHVBK 20180317142955.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1007/s00540-011-1130-7 doi (NATIONALLICENCE)springer-10.1007/s00540-011-1130-7 Fast-track postoperative care for neonatal cardiac surgery: a single-institute experience [Elektronische Daten] [Yuka Yamasaki, Nobuaki Shime, Takako Miyazaki, Masaaki Yamagishi, Satoru Hashimoto, Yoshifumi Tanaka] Purpose: Perioperative fast-track management has gained wide acceptance in the field of neonatal corrective heart surgery. We have examined its impact on morbidity outcomes. Methods: Between 1997 and 2009, 52 consecutive neonates underwent corrective repair of congenital heart defects on cardiopulmonary bypass. Fast-track management was introduced in 2006 with the aim of simplifying care; it includes early postoperative extubation with low-dose fentanyl and an pulse oximeter oxygen saturation (SpO2) target of ≤95%, early removal of indwelling lines, and early introduction of early enteral feeding. This was a retrospective review of the medical records in which perioperative characteristics and outcomes of patients operated on prior to the introduction of fast-track management care (controls, group C) were compared with those operated on following its introduction (fast-track group, group F). Results: Intraoperative fentanyl was administered in significantly lower doses in group F (29.5±11.5μg/kg) than in group C (65.6±34.0μg/kg) (p<0.001). The median number of days of postoperative mechanical ventilation and inotrope administration was significantly lower in group F (2 and 4 days, respectively) than in group C (9 and 9 days, respectively) (p<0.001 and p=0.003). More patients (p<0.001) in group F (56.3%) than in group C (0%) was extubated within <24h. The median number of days to postoperative weight recovery was significantly lower in group F (16 days) than in group C (29 days) (p=0.003). Finally, the median number of days in the Intensive Care Unit was significantly lower (p=0.01) in group F than in group C (16 vs. 26 days, respectively). Mortality in group F was 0% versus 17% in group C (p=0.21). Conclusions: Fast-track management with simple care for neonates undergoing complete biventricular repair of congenital heart defects was associated with better postoperative recovery. Japanese Society of Anesthesiologists, 2011 Neonatal care nationallicence Postoperative care nationallicence Cardiac surgery nationallicence Congenital heart disease nationallicence Early extubation nationallicence Yamasaki Yuka Intensive Care Division, Department of Anesthesiology and Intensive Care, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kamigyo-ku, 602-8566, Kyoto, Japan aut Shime Nobuaki Intensive Care Division, Department of Anesthesiology and Intensive Care, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kamigyo-ku, 602-8566, Kyoto, Japan aut Miyazaki Takako Department of Pediatric Cardiac Surgery, School of Medical Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan aut Yamagishi Masaaki Department of Pediatric Cardiac Surgery, School of Medical Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan aut Hashimoto Satoru Intensive Care Division, Department of Anesthesiology and Intensive Care, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kamigyo-ku, 602-8566, Kyoto, Japan aut Tanaka Yoshifumi Intensive Care Division, Department of Anesthesiology and Intensive Care, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kamigyo-ku, 602-8566, Kyoto, Japan aut Journal of Anesthesia Springer Japan 25/3(2011-06-01), 321-329 0913-8668 25:3<321 2011 25 540 https://doi.org/10.1007/s00540-011-1130-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-011-1130-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Yamasaki Yuka Intensive Care Division, Department of Anesthesiology and Intensive Care, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kamigyo-ku, 602-8566, Kyoto, Japan aut NATIONALLICENCE 700 1- Shime Nobuaki Intensive Care Division, Department of Anesthesiology and Intensive Care, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kamigyo-ku, 602-8566, Kyoto, Japan aut NATIONALLICENCE 700 1- Miyazaki Takako Department of Pediatric Cardiac Surgery, School of Medical Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan aut NATIONALLICENCE 700 1- Yamagishi Masaaki Department of Pediatric Cardiac Surgery, School of Medical Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan aut NATIONALLICENCE 700 1- Hashimoto Satoru Intensive Care Division, Department of Anesthesiology and Intensive Care, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kamigyo-ku, 602-8566, Kyoto, Japan aut NATIONALLICENCE 700 1- Tanaka Yoshifumi Intensive Care Division, Department of Anesthesiology and Intensive Care, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kamigyo-ku, 602-8566, Kyoto, Japan aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/3(2011-06-01), 321-329 0913-8668 25:3<321 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer