Table 1 Substantial differences in PACU vs. ICU treatment
PACU group | ICU group | |
|---|---|---|
Physician-to-patient ratio | 1:3 | 1:12 |
Nurse-to-patient ratio | 1:3 | 1:2 |
Physicians specialisation | All anaesthesiologists | Diverse specialisations (for example cardiac surgeon) |
Beds available | 3 bed unit | 21 bed unit |
Opening time | Limited opening time | Unlimited opening, 24 hours |
Patient population | Only elective cardiac surgery patients after pre- and postoperative evaluation of fast-track suitability that PACU staff can focus on | Mixed, as in the PACU but additionally patients in need of physicians’ attention due to multimorbidity and severe diseases (for example non-fast-track patients) |
Analgesia regime | Strict regime as described in method section | Performed more liberally according to nurses estimation |
Pain scale for pain assessment. | ||
Timing of extubation | As soon as extubation criteria were met | According to physicians’ estimation under consideration of overall situation on the ICU presupposed that extubation criteria were met |
Weaning protocol | Performed by physician | Mainly nurse-driven |
Good compliance to the protocol | Compliance to the weaning protocol depended on the actual workload | |
Stop of analgosedation | Remifentanil stopped at arrival (after paracetamol and piritramid were administered | Remifentanil stop according to disposition of the intensivist under consideration of overall situation on the ICU |
Non-invasive ventilation | Performed routinely | Performed in only 4% of our population |
Discharge to step-down unit. | Patient were discharged to step-down unit as soon as they met discharge criteria | Discharge to the step-down unit depended on need for ICU beds |