Abstract
Background: Coronary artery bypass graft (CABG) with cardiopulmonary bypass (CPB) is a high-risk surgery with significant morbidity resulting in a prolonged stay in the intensive care unit (ICU) at an increased cost. Early goal-directed therapy (EGDT) using the FloTrac/EV1000 platform improved outcomes in these patients with shorter ICU stay but with extra cost for a FloTrac transducer. Objective: To assess the cost-effectiveness of implementing the FloTrac/EV1000 in these patients. Materials and Methods: The present study was a retrospective study. Sixty adult patients who underwent CABG with CPB were included and divided into two groups: the EV1000 and the Control group. The EV1000 group was managed with EGDT protocol using FloTrac/EV1000 platform. The Control group was managed using a standard protocol. The ICU and hospital stay of both groups were compared. Then, the authors assessed the daily ICU cost by including another 62 patients admitted to the cardiovascular and thoracic (CVT) ICU. Finally, the extra cost of a FloTrac transducer was compared with the saved CVT ICU cost. Results: The EV1000 group had a shorter CVT ICU stay, with mean difference of –23.7 h (95% CI –34.5 to –12.9, p<0.001). The EV1000 group had a shorter ventilator time, as well as a shorter hospital stay. The average daily CVT ICU cost was 10,020.05 Baht. The extra cost of a FloTrac sensor was 5,000 Baht. The saved cost of CVT ICU exceeds the cost of a FloTrac by 5,020.05 Baht. Conclusion: The implementation of EGDT using the FloTrac/EV1000 platform in patients undergoing CABG with CPB improved patients’ outcomes resulting in less CVT ICU cost and better resource management of CVT ICU beds. The extra cost of the FloTrac sensor was offset by the larger amount of CVT ICU cost that was saved. Keywords: Cost-effectiveness; Early goal-directed therapy; FloTrac; Intensive care unit; ICU stay
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