Guidelines for INTENSIVE CARE IN Cardiac Surgery PATIENTS

Posted by e-Medical PPT Wednesday, December 25, 2013
Basic principles of the postoperative intensive care of patients after cardiothoracic surgery:
Hemodynamic monitoring
Volume-therapy
Treatment with inotropic drugs and vasopressors

Goals for cardio-circulatory therapy
The goal of fluid management and inotropic and vasoactive drug therapy in post-operative cardiac surgery patients
is to achieve sufficient tissue perfusion and a normalization of oxidative metabolism.

Cardiac output and oxygen supply are dependent on adequate intravascular volume and cardiac function.

The following parameters are recommended as goals for postoperative cardiovascular therapies.

Blood Pressure targets during the first 48 hours:

Normal (MAP >65 mm Hg)     Default BP goal
High (MAP >75 mm Hg)         Age >75
                Poorly controlled HTN
                Pre- or postop- renal impairment
                Uncorrected carotid artery stenosis
                Pre- or postop- ischemic stroke
Low (MAP 55-60 mm Hg)         Age <50 (with low preop- BP)
                High bleeding risk
                Surgery for chronic valve regurgitation

INITIAL ASSESSMENT on ADMISSION TO ICU
Cardiovascular system, ECG, arrhythmias
Verify vasoactive & inotropic drugs, pacemaker, IABP
Respiratory system, ventilator settings, ABG, CXR
Chest drains, bleeding, coagulation tests
Renal system, fluid & electrolytes
Pupil size & reactivity, level of sedation
Core temperature, warming device

ADVANCED HEMODYNAMIC MONITORING
Pulmonary artery catheter: is justified in high risk patients for complex cardiac surgery interventions,
in low cardiac output syndrome,pulmonary hypertension,and for the differentiation between right or left ventricular dysfunction.

The use of a PAC in cardiac surgery patients with a low perioperative risk is not considered necessary.

Related Posts Plugin for WordPress, Blogger...

0 Responses to Guidelines for INTENSIVE CARE IN Cardiac Surgery PATIENTS

Post a Comment

We are on Google+

Share This

GET UPDATES!!!

Subscribe by E-mail & receive updates your inbox!
Enter your email address:

Follow Us on Facebook

Blog Archive