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Initial Review of the Postoperative Patient ABC Monitoring IV lines and sites Pumps and infusions Drain catheters and urinary catheter Temperature Physical examination CABG patients looking to develop of impo. Postoperative Management Ventilation CXR heart skips a beat heart skips a beat ETT and chest tube placement, SG-catheter position, and pulmonary pathology ABG for ventilation assessment and support Circulation Pressor needs.

Postoperative Medications Aspirin Start within first 48 (24) h boehringer ingelheim gmbh co kg op. Postoperative Complications Bleeding Surgical. Prolonged ventilation Increased risk of VAP Hypertension. Problem Directed Management Fort Pain. Tachycardia and pronounced hypotension, usefulness in ICU patients unclear Hyperglycemia 40.

Dkips Directed Management Hyperglycemia Insulin infusion to maintain blood glucose Arrhythmias 41. Problem Directed Management Arrhythmias Amiodarone has good prophylactic effect and shown good rhythm control on postoperative AF. Give bewt protamine Intraoperative major bleed. Special Small non small cell lung cancer Postoperative vasodilatory shock Common post CBP and probably exacerbated by preoperative use of ACE-inhibitor and intraop milrinone.

CPB appears to stimulate nitric oxide production thru skkips effect beqt the inducible NOS. SIRS Use of low-dose steroids seems to attenuate cytokine response post bypass and improve outcome.

Gunjan YG et al. Augmentin 400mg hyperglycemia and perioperative outcomes in cardiac surgery patients.

Van den Berghe et al. Intensive insulin therapy in the critically ill patients. Practice Advisory for the Perioperative Management of Ademetionine with Cardiac Rhythm Management Devices: Pacemakers and Implantable Cardioverter-Defibrillators.

Louis E Samuels et al. Selective use of amiodarone and early cardioversion for postoperative atrial fibrillation. Eugene Chrystal et al. Interventions on prevention of postoperative atrial fibrillation in patients undergoing heart surgery: a meta analysis. Erich Kilger et al. References (cont) Erich Kilger et al.

Stress doses of hydrocortisone reduce severe systemic inflammatory response syndrome and improve early outcome in a risk group of patients after cardiac surgery. Roger JF, Baskett et al. The intraaortic balloon pump in cardiac surgery. Heart skips a beat heart skips a beat Therapy for Pulmonary Arterial Hypertension, ACCP Evidence-Based Clinical Practice Guidelines. Statins decrease perioperative cardiac complications in patients undergoing noncardiac vascular surgery: the statins for risk reduction in surgery (StaRRS) study.

J Am Coll Cardiol. Arginine vasopressin in advanced vasodilatory heart skips a beat heart skips a beat a prospective, randomized, controlled study. The effects of vasopressin on systemic hemodynamics in catecholamine-resistant septic and postcardiotomy shock: a retrospective analysis. References (cont) Dennis T Mangano. Emile G Daoud, et al.

Preoperative amiodarone as prophylaxis against atrial fibrillation after heart surgery. Trevor WR Lee, et al. High spinal anesthesia could cardiac surgery. Stefan G de Kennedy, et al. Choice of primary anesthetic regimen can influence Coumadin (Warfarin Sodium)- FDA care unit length of stay after coronary surgery with cardiopulmonary bypass.

Stefan G De Hert, et al. Cardioprotection with volatile anesthetics: mechanism and clinical implications.



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