{"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

<\/span>Post-CABG<\/span><\/h2>\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

<\/span>Pressure Failure<\/span><\/h3>\n

Aortic Stenosis<\/p>\n

AV synchrony is key<\/p>\n

HR 90-100<\/p>\n

Give Volume<\/p>\n

<\/span>Volume Failure<\/span><\/h3>\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

 <\/p>\n

 <\/p>\n

<\/span>Acute Graft Closure<\/span><\/h3>\n

Get a 12 lead, look especially at t-waves<\/p>\n

<\/span>Post-Operative Bleeding<\/span><\/h3>\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

<\/span>Ventricular Fibrillation<\/span><\/h3>\n

It is sick coronary until proven otherwise<\/p>\n

 <\/p>\n

<\/span>Left Ventricular Assist Devices (LVADS)<\/span><\/h2>\n

 <\/p>\n

<\/span>ACLS for Post-Sternotomy Patients<\/span><\/h2>\n

Guideline Document for ACLS for CSICU<\/a><\/p>\n

<\/span>TAVR \/ TAVI (Transcatheter Aortic Valve Implantation and Transcatheter Aortic Valve Replacement)<\/span><\/h2>\n

for severe aortic stenosis<\/p>\n

TTE\/CT Scan\/Coronary Angiography as prescreen<\/p>\n

<\/span>Surgical Aortic Valve Replacement (SAVR)<\/span><\/h2>\n

 <\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

best book: Manual of Perioperative Medicine by Bojar Post-CABG what was bypassed? discrete lesion vs. diffuse disease what was the graft material? art vs. vein, pedicle vs. free Looking for MAP 70-80 and DBP>50 First 6 hours, need CI>2.0 Hb 8.0 Fix acidosis CVP is actually a good monitor of RV failure Consider SWAN if […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[18,27],"tags":[],"yoast_head":"\nCardiothoracic Surgical Intensive Care - Crashing Patient<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/crashingpatient.com\/intensive-care\/cardiac-surgical-icu.htm\/\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"CrashMaster\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/crashingpatient.com\/intensive-care\/cardiac-surgical-icu.htm\/\",\"url\":\"https:\/\/crashingpatient.com\/intensive-care\/cardiac-surgical-icu.htm\/\",\"name\":\"Cardiothoracic Surgical Intensive Care - 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