Who says you cant fast-track if you intubate the trachea.
All your cases that you intubate for non-cardiac surgeries you extubate at the end of surgery. Dont You?
Fast tracking in cardiac surgeries is dependant on lot of other factors like haemodynamics, extent of myocardial repairs, inotorpic support, arrhythmias etc. Not merely the presence or absence of ETT.
With so much of lung retraction for cardiac surgery how can you acheive adequate peak inflation pressure to ventilate adequately with LMA - results in inadequate alveolar ventialtion
In classic LMA permitted peak inflation press is 18 cm H2O.
In proseal LMA permitted peak pressure is 30.
Spontaneous ventilation is not desired in cardiac surgery. LMA and spont vent is usually associated with hypercarbia usually between 50 to 60 mmHg. This is definitely unacceptable in cardiac surgery
SO doctor , current scientific evidence showing safe practice both for your patient and you is
Intubate cardiac surgery patients with cuffed ETT, control ventilation
end of surgery if they meet all required criteria for fast tracking
reverse and extubate
WHO KNOWS WHAT THE FUTURE SCIENTIFIC EVIDENCE HOLDS IN STORE