Peri-operative care, ICU care and fluid management

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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.

Original languageEnglish
Title of host publicationManagement of Heart Failure
Subtitle of host publicationVolume 2: Surgical
EditorsJai Raman
Place of PublicationLondon UK
PublisherSpringer
Chapter18
Pages269-282
Number of pages13
Volume2
Edition2nd
ISBN (Electronic)9781447142799
ISBN (Print)9781447142782
DOIs
Publication statusPublished - 1 Jan 2016
Externally publishedYes

Keywords

  • Cardiac output
  • Coagulation
  • Fluids
  • Infection
  • Inotropes
  • Vasopresssors

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