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

Wednesday, November 19, 2025

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.  

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. 


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Comments

A great start to the series, I look forward to hearing more. Please can speakers share evidence for their comments especially in reference to routine post-op x-rays? As mentioned it is difficult to change practice when policies have been in place for many years. I hope that you discuss use of temporary epicardial pacing wires and indication and duration of chest drains following various thoracic surgeries. Many thanks

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