{"id":9403,"date":"2013-12-03T17:24:45","date_gmt":"2013-12-03T22:24:45","guid":{"rendered":"https:\/\/crashingpatient.com\/?p=9403"},"modified":"2014-10-05T23:46:23","modified_gmt":"2014-10-06T03:46:23","slug":"cardiac-surgical-icu","status":"publish","type":"post","link":"https:\/\/crashingpatient.com\/intensive-care\/cardiac-surgical-icu.htm\/","title":{"rendered":"Cardiothoracic Surgical Intensive Care"},"content":{"rendered":"
best book: Manual of Perioperative Medicine by Bojar<\/p>\n
what was bypassed? discrete lesion vs. diffuse disease<\/p>\n
what was the graft material? art vs. vein, pedicle vs. free<\/p>\n
Looking for MAP 70-80 and DBP>50<\/p>\n
First 6 hours, need CI>2.0<\/p>\n
Hb 8.0<\/p>\n
Fix acidosis<\/p>\n
CVP is actually a good monitor of RV failure<\/p>\n
Consider SWAN if EF<40%, Aortic Valves c CABG, Mitral\/Tricuspids, CHF\/Cardiomyopathy, Jehovah’s pts<\/p>\n
Aortic Stenosis<\/p>\n
AV synchrony is key<\/p>\n
HR 90-100<\/p>\n
Give Volume<\/p>\n
Mitral Valves<\/p>\n
More tolerant of tachycardia<\/p>\n
Give fluid until pulm diastolic bumps 3 points<\/p>\n
2-4 liters<\/p>\n
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Get a 12 lead, look especially at t-waves<\/p>\n
Blood climbing the chest tube against gravity is bad<\/p>\n
Tachycardia<\/p>\n
Amio 150 mg q 30-60 minutes up to 900 mg\/day. Don’t bother with the drip<\/p>\n
Flutter-needs dilt, not amio<\/p>\n
It is sick coronary until proven otherwise<\/p>\n
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