The Cardiac Recovery Room: Cardiac Surgery Myths Busted—Separating Fact From Fiction

In this inaugural episode of CTSNet’s new podcast, The Cardiac Recovery Room, moderator Dr. Daniel Engelman, Medical Director of the Cardiac Surgical Critical Care & Inpatient Services at Baystate Health, Professor of Surgery at the University of Massachusetts Chan Medical School—Baystate, and President of the ERAS Cardiac Society, spoke with Drs. Rakesh Arora, Director of Perioperative and Cardiac Critical Care and Research Director in the Division of Cardiac Surgery at University Hospitals Harrington Heart & Vascular Institute in Cleveland, Ohio, USA, and Michael C. Grant, Associate Professor at Johns Hopkins University School of Medicine in the Department of Anesthesiology and Critical Care Medicine, about cardiac surgery myths.   Chapters 00:54 Are There Myths? 02:49 Applying Non-Cardiac Surgery Data 04:52 Reducing NPO, Diabetes Carb-Load 08:17 Postop, Crystalloid Volume 10:31 Bicarb Usage 12:10 Hematocrit & Hemoglobin 14:53 Bronchoscopy for Early Extubation 18:54 Routine X-Rays 22:19 Lactates 24:48 Sleeplessness & Delirium 31:14 Final Thoughts They discuss important topics such as the rationale for reducing nothing by mouth (NPO) guidelines, NPO after midnight, and the implications of carbohydrate loading for patients with type 1 diabetes. They examine critical issues of volume resuscitation, comparing the use of albumin vs crystalloids, as well as bicarb usage. Additionally, they evaluate hematocrit and hemoglobin levels, questioning whether specific thresholds should be established. The conversation also covers bronchoscopy for early extubation, inline suctioning for a bronchoalveolar lavage (BAL), and the necessity of daily chest x-rays following cardiac surgery. Furthermore, they address topics such as lactates, sleep aids, and delirium.  The Cardiac Recovery Room is the place to hear the conversations colleagues are having after the meetings. Each month, a new episode will be released featuring a leadership panel from the ERAS Cardiac Society.  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

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