R Scott Stephens1, Glenn J R Whitman. 1. 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.
Abstract
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.
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.
Authors: Michael R Mathis; Neal M Duggal; Donald S Likosky; Jonathan W Haft; Nicholas J Douville; Michelle T Vaughn; Michael D Maile; Randal S Blank; Douglas A Colquhoun; Raymond J Strobel; Allison M Janda; Min Zhang; Sachin Kheterpal; Milo C Engoren Journal: Anesthesiology Date: 2019-11 Impact factor: 7.892
Authors: Emily Foreman; Morgan Eddy; Jenny Holdcombe; Phoebe Warren; Lisa Gebicke; Pamela Raney; Wilson Clements; James Zellner Journal: J Extra Corpor Technol Date: 2021-12
Authors: Mitsunori Nakano; Yohei Nomura; Glenn Whitman; Marc Sussman; Stefano Schena; Ahmet Kilic; Chun W Choi; Kei Akiyoshi; Karin J Neufeld; Jennifer Lawton; Elizabeth Colantuoni; Atsushi Yamaguchi; Matthew Wen; Peter Smielewski; Ken Brady; Brian Bush; Charles W Hogue; Charles H Brown Journal: Br J Anaesth Date: 2021-03-23 Impact factor: 9.166
Authors: Thomas S Metkus; Dylan Thibault; Michael C Grant; Vinay Badhwar; Jeffrey P Jacobs; Jennifer Lawton; Sean M O'Brien; Vinod Thourani; Zachary K Wegermann; Brittany Zwischenberger; Robert Higgins Journal: J Am Coll Cardiol Date: 2021-05-03 Impact factor: 27.203