Cardiothoracic & vascular anesthesia
FloTrac-Guided Hemodynamic Monitoring Optimizes Enhanced Recovery After Surgery (ERAS) Implementation in Coronary Artery Bypass Surgery: A Retrospective Three-Phase Analysis
Main finding · Extubation timeResult — go to the resultReduction in mean extubation time 43% hours 95% CI −6.26 to −2.50Authors' conclusion
ERAS implementation was associated with modest improvements in extubation time, while full protocol integration with hemodynamic monitoring (phase 3) demonstrated the most favorable outcomes in extubation time and perioperative hemodynamic stability.
Study context
- Population
- Patients undergoing elective isolated CABG (isolated coronary artery bypass grafting (ISO-CABG)), January-December 2024
- Participants
- 380 patients
- Exposure
- Phase 1 vs Phase 2 vs Phase 3
- Phase 1n = 238reference
- Phase 2n = 119
- Phase 3n = 23
- Outcome
- Extubation time and intensive care unit (ICU) LOS
Methodological detailsretrospective analysis of prospectively collected data, three-phase before-after comparison
- Retrospective analysis of prospectively collected data
- Three-phase before-after comparison
Main finding
Extubation time
Reduction in mean extubation time
43% hours
95% CI −6.26 to −2.50
P < 0.001
By group
Phase 1
10 hours 17 minutes
mean · SD 4.5
Phase 2
9 hours 27 minutes
mean · SD 5.2
Phase 3
5 hours 54 minutes
mean · SD 3.0
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
Hypotension duration (MAP <65 mmHg) — Phase 3 vs Phase 1 · CI in minutes
reduction (minutes) 74% (−45.2 to −30.2) · P < 0.001
| Outcome | Phase 1 | Phase 2 | Phase 3 | P value |
|---|---|---|---|---|
| ICU LOS (primary outcome)Phase 3 vs Phase 1 · not significantly different · non-linear pattern | 34:52 (SD 12.0) hours | 41:27 (SD 18.0) hours | 32:58 (SD 13.0) hours | P = 0.472 |
| ICU LOS (primary outcome)Phase 3 vs Phase 2 · significantly shorter · non-linear pattern | P = 0.033 | |||
| Area under threshold (AUT, mmHg*min) | 218 | 260 | 88 | |
| Time-weighted average (TWA) MAP <65 mmHg | 0.33 | 0.24 | 0.07 |
- Area under threshold (AUT, mmHg*min): p = 0.006
- Time-weighted average (TWA) MAP <65 mmHg: p < 0.001
Original publication
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