ICU Management Following Heart Transplantation

First Things First

• Airway
• Breathing
  • Minimize FiO2 and PEEP to keep SaO2 >92%

• Circulation
  • Transplanted hearts are denervated and are prone to biventricular dysfunction.
  • RV dysfunction is more common.
  • Often, a variable combination of vasoactive agents, inotropic support and rarely temporary pacing is needed.
  • Transesophageal echo is a useful tool in postop management.

• Bleeding can also occur.