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• W2893304831 abstract "Studies have suggested that intensivist led or closed CVICU models, as opposed to a cardiac surgeon led or open CVICU models, are associated with improved patient outcomes. However, the majority of these studies have been limited by the absence of open model data. Patients undergoing cardiac surgery at the New Brunswick Heart Centre (NBHC) have traditionally been admitted to a cardiac surgeon-led open CVICU following surgery. The objective of this study was to determine if an open model CVICU has been effective in providing intensive care to cardiac surgery patients over time at the NBHC. A total of 6102 patients who underwent non-emergent cardiac surgery from 2006 to 2014 at the NBHC were included. [A-2006-2008: n=1944(32%); B-2009-2011: n=2106(35%); C-2012-2014: n=2052(33%)]. Comparisons were carried out on the basis of baseline/intraoperative characteristics and in-hospital outcomes. Preoperative comorbidities, including hypertension (A:66.2%; B:71.4; C:71.1, p<0.001), cerebrovascular disease (A:7.9%; B:12.0; C:12.6, p<0.001), COPD (A:8.3%; B:10.7; C:10.9, p=0.01), and NYHA 4 functional status (A:29.5%; B:35.2; C:56.1, p<0.001) were more prevalent in recent years. Procedures were more complex in recent years with the number of isolated coronary artery bypass grafts lessening (A:69.1%; B:63.3; C:61, p<0.001). Despite this, postoperative outcomes have improved over time. Patients operated on between 2012-2014 had shorter median ICU length of stay (A:1270min; B:1249; C:1255,p=0.001) and initial ventilation times (A:398min; B:385; C:358, p<0.001), had lower ICU readmission rates (A:2.6%; B:3.8; C:2.3, p=0.007), and higher rates of ICU fast tracking (A:1.6%; B:4.1; C:3.6, p<0.001). When compared to results in the literature, these outcomes were found to be comparable if not superior in terms of ventilation time, ICU stay, and mortality. As patients’ comorbidities worsened and their cases became more complex, post-operative outcomes improved in an open model CVICU over time. The results of this study demonstrate the effectiveness of an open model CVICU in treating a contemporary cohort of patients undergoing cardiac surgery." @default.
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• W2893304831 date "2018-10-01" @default.
• W2893304831 modified "2023-09-25" @default.
• W2893304831 title "A DESCRIPTIVE ANALYSIS OF AN OPEN INTENSIVE CARE UNIT MODEL IN PATIENTS UNDERGOING CARDIAC SURGERY AT THE NEW BRUNSWICK HEART CENTRE" @default.
• W2893304831 doi "https://doi.org/10.1016/j.cjca.2018.07.405" @default.
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