ICU Management Following Cardiac Surgery

ICU Management Following Cardiac Surgery is a topic covered in the Pocket ICU Management.

To view the entire topic, please or purchase a subscription.

Anesthesia Central is an all-in-one web and mobile solution for treating patients before, during, and after surgery. This collection of drug, procedures and test information is derived from Davis’s Drug, MGH Clinical Anesthesia Procedures, Pocket Guide to Diagnostic Tests, and MEDLINE Journals. Explore these free sample topics:

Anesthesia Central

-- The first section of this topic is shown below --

First Things First

  • Get report from surgery/anesthesia team and assess for the following:


  • Security and depth of ETT upon arrival
  • Difficulties with intubation


  • Oximetric saturation and PaO2 for a given amount of FiO2 and PEEP


  • pH and pCO2 for a given tidal volume, respiratory rate and peak inspiratory pressure


  • MAP, SBP and DBP, as supported by
    • CO, SVR, CVP, PAOP/PAD, rhythm
    • Hemodynamically active drug infusions
  • Correlation of filling pressures with ventricular dimensions on 2D TEE
  • Intraoperative segmental wall motion abnormalities
  • Intraoperative TEE assessment of native valves, replaced/repaired valves
  • ASD or VSD?
  • IABP timing and adequacy of both systolic and diastolic augmentation
  • General function of LVAD, RVAD or BIVAD


  • Bladder and core (intravascular) temperature
  • Degree to which patient was cooled and subsequently warmed intraoperatively

Fluids, electrolytes and renal function

  • Intraoperative measures of electrolytes (most notably last values for potassium)
  • Total fluids and blood products
  • Intraoperative urine output

Hematological (oxygen carrying capacity)

  • Estimates of blood loss
  • Salvaged blood returned
  • Total PRBC products administered

Hematological (capacity to clot)

  • ACT
    • Prebypass
    • Post heparin
    • Postbypass
    • Post protamine
  • Amount of heparin administered in total, types and amounts of non-PRBC blood products (platelets, FFP, cryoprecipitate)
  • Hematologically active drugs administered (aminocaproic acid, tranexemic acid, DDAVP)


  • Intraoperative blood glucoses
  • Amount and route of insulin given
  • Infectious disease defenses
  • Timing and dose of perioperative antibiotics


  • Type, timing and doses of:
    • Narcotics, benzodiazepines
    • Neuromuscular blocking agents,
    • Volatile anesthetics, intravenous anesthetics

Surgical specifics

  • Bypass grafts
    • Number
    • Location
    • Types performed (vein, radial, mammary, etc.)
  • Any portion of diseased coronary circulation not amenable to bypass
  • Type and location of valvular replacement/repair
  • Total CPB time, total cross-clamp time

-- To view the remaining sections of this topic, please or purchase a subscription --

Last updated: April 22, 2010