Early Postoperative Care After Cardiac Surgery

The early postoperative course for most patients after cardiac surgery is characterized by a typical pattern of pathophysiologic derangements that benefits form standardized care. Multimodal, multidisciplinary standardization of the care process has been shown to improve use of resources, efficiency, quality, safety and patient satisfaction. The initial management in the postoperative care after routine cardiac surgery has fundamentally shifted during the past two decades towards a more efficient use of limited postoperative care facilities, early extubation and rapid discharge. The fast-track protocol became feasible after cardiac surgery due to improvements in perioperative anaesthesia management, new surgical techniques, better myocardial protection and cardiopulmonary bypass techniques and to better management of bleeding using point-of-care testing and new hemostatic drugs. This chapter will briefly discuss the major pathophysiologic derangements and their management during the first 24 hours after surgery. It will than summarize the postoperative care to more specific procedures. Finally, the management of common postoperative complications will be discussed.