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Postoperative Critical Care of the Adult Cardiac Surgical Patient. Part I: Routine Postoperative Care

Stephens, R. Scott MD1,2; Whitman, Glenn J. R. MD2,3

doi: 10.1097/CCM.0000000000001059
Concise Definitive Review

Objectives: Cardiac surgery, including coronary artery bypass, cardiac valve, and aortic procedures, is among the most common surgical procedures performed in the United States. Successful outcomes after cardiac surgery depend on optimum postoperative critical care. The cardiac intensivist must have a comprehensive understanding of cardiopulmonary physiology and the sequelae of cardiopulmonary bypass. In this concise review, targeted at intensivists and surgeons, we discuss the routine management of the postoperative cardiac surgical patient.

Data Source and Synthesis: Narrative review of relevant English-language peer-reviewed medical literature.

Conclusions: Critical care of the cardiac surgical patient is a complex and dynamic endeavor. Adequate fluid resuscitation, appropriate inotropic support, attention to rewarming, and ventilator management are key components. Patient safety is enhanced by experienced personnel, a structured handover between the operating room and ICU teams, and appropriate transfusion strategies.

1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD.

2Cardiovascular Surgical Intensive Care Unit, Johns Hopkins Hospital, Baltimore, MD.

3Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University, Baltimore, MD.

Dr. Whitman’s institution lectured and provided expert testimony. Dr. Stephens has disclosed that he does not have any potential conflicts of interest.

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