Recovery from coronary artery bypass surgery in a community hospital: Post anesthesia care unit (PACU) versus intensive care unit (ICU)

Introduction: study was conducted in a community hospital to compare outcomes in open-heart surgery patients recovered in the PACU versus the ICU. Methods:With IRB approval patients were screened for eligibility according to selection criteria: Age (less than 70 years), ejection fraction (EF) above 45% and no co-morbid conditions. Patients were randomly assigned to the PACU (18) or the ICU (20). Data were analyzed by Student's t test. All values are mean ± s.d. Results:There was no significant difference in age (60 ± 8 yrs PACU vs. 59 ± 8 yrs ICU), EF (60 ± 7% vs. 60 ± 5%), number of grafts (4 ± 1 vs. 5 ± 1) or APACHE III scores (35 ± 8 vs. 36 ± 9) between the two groups. However, duration of intubation was reduced by 70% (1.9 ± 0.9 hrs PACU vs. 6.5 ± 2.9 hrs ICU, p < 0.001) and duration of stay by 67% (4.9 ± 0.7 hrs PACU vs. 15 ± 6 hrs ICU, p < 0.001) when patients recovered in the PACU. There was no difference in hospital stay between the two groups (5.3 ± 2.2 days PACU vs. 5.4 ± 2 days ICU). Conclusion:In this study recovery of cardiac surgical patients in the PACU was associated with shorter intubation and recovery times when compared to a similar group recovered in the ICU. In addition, no reintubations or readmissions from the ward to the ICU were observed in either group. The environment, nursing care, and the fact that anesthesiologists are more directly involved in the recovery and weaning process may be important factors in a better outcome from the PACU.