Ultrafast Tracking in Pediatric Cardiac Surgery

The ultrafast track protocol describes in detail the pre-, intra-, and postoperative procedures, which in their entirety aim to extubate all children, who have undergone pediatric cardiac surgery, on the operating table. The knows only a few exceptions from this general rule, e.g. the Norwood-stage I operation or premature infants, who are on mechanical ventilation before surgery. The concept of early extubation with its advantages and disadvantages is critically questioned from a pathophysiological perspective. In addition, the effects of the ultrafast track concept on important patient-centered outcomes and on patient safety are discussed in detail. Another focus of the chapter is the characterization of the pharmacokinetic and pharmacodynamic properties of the centrally acting substances used for anesthesia and postoperative analgesia.