GIRFT Cardiothoracic Surgery Report: RCoA response

Responding to the launch of the GIRFT Cardiothoracic Surgery Report, Dr Chris Snowden, joint clinical lead for the Anaesthetic and Perioperative Medicine GIRFT programme, said:

“The Royal College of Anaesthetists is pleased that the GIRFT Cardiothoracic Surgery Report highlights several important topics directly related to anaesthesia and perioperative medicine.

“Based on the report’s findings across 31 NHS cardiothoracic units in England, one of the most important recommendations is the increased use of day of surgery admission. In perioperative terms, it is very important to see greater emphasis being placed on identifying and addressing patient risk during preoperative assessments, in both elective cases and urgent referrals.

“Furthermore, the report comments that successful cardiothoracic outcomes remain in most situations unrelated to patients’ age. This highlights the fact that enhanced patient care will come from emphasis on the preoperative identification of high-risk individuals and the successful treatment of their pre-existing comorbidities rather than an assessment on age alone.

“It is also pleasing to see highlighted, the importance of blood management systems and the preoperative use of intravenous iron to treat anaemia and prevent variation in perioperative blood product use. This has been a priority for the RCoA perioperative program and we are pleased to see this recommendation being implemented in the GIRFT setting.

“Of course, critical care availability is a major factor within cardiothoracic surgery. The report stresses the importance of treating high-risk patients in critical care settings, rather than its widespread use for all patients (especially use on lower risk patients). The success of cardiothoracic surgical teams to discharge their patients from critical care relies on the appropriate use of a skilled perioperative care team and shared responsibility of care.

“In all, the effective use of the perioperative pathway within cardiothoracic surgery is key to delivering the right care, to the right patients at the right time.”

11 April 2018