Peri-operative care, ICU care and fluid management

Abstract

The peri-operative care of cardiac surgery patients is complex and dynamic. Hemodynamic management is of pivotal importance and, in many patients, requires invasive monitoring of filling pressures and cardiac output. In a significant proportion of patients hemodynamic support requires not only the administration of fluids but also the administration of vasopressor and inotropic drugs. Such therapy mandates continuous measurement of pressure and flow. In very unstable patients, mechanical intervention with intra-aortic balloon counterpulsation and extracorporeal membrane oxygenation may also become necessary. Management of bleeding can also become a problem and require aggressive administration of blood products or concentrated clotting factors. Adequate sedation, prevention of infection, treatment of acute renal failure, safe mechanical ventilation and treatment of metabolic and acid-base disorders are also frequent and important.