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Postoperative Critical Care of the Adult Cardiac Surgical Patient: Part II Procedure-Specific Considerations, Management of Complications, and Quality Improvement

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

doi: 10.1097/CCM.0000000000001171
Concise Definitive Review

Objectives: The armamentarium of cardiac surgery continues to expand, and the cardiac intensivist must be familiar with a broad spectrum of procedures and their specific management concerns. In the conclusion of this two-part review, we will review procedure-specific concerns after cardiac surgery and the management of common complications. We also discuss performance improvement and outcome assurance.

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

Conclusions: Knowledge of procedure-specific sequelae informs anticipation and prevention of many complications after cardiac surgery. Most complications after cardiac surgery fall into a limited number of categories. Familiarity with common complications combined with a structured approach to management facilitates response to even the most complicated postoperative situations. Standardized care and constant self-examination are essential for programmatic improvement and consistent high-quality care.

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

2Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University, Baltimore, MD.

3Cardiovascular Surgical Intensive Care Unit, Johns Hopkins Hospital, Johns Hopkins University, Baltimore, MD.

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

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