Cardiovascular Complications and Management After Cardiac Surgery
The essential principle in post-cardiac surgical care is ensuring optimal hemodynamic preservation and tissue perfusion through the utilization of continuous hemodynamic monitoring, adequate volume repletion, and, if necessary, use of inotropic agents and
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Cardiovascular Complications and Management After Cardiac Surgery Mahnoosh Foroughi and Antonio Hernandez Conte
Contents 7.1
Cardiac Monitoring ......................................................................................................... 7.1.1 Cardiovascular Effects of Common Inotropic Agents ........................................ 7.2 Cardiac Complications .................................................................................................... 7.2.1 Postoperative Myocardial Ischemia .................................................................... 7.2.2 Hemodynamic Instability .................................................................................... 7.2.3 Arrhythmias ........................................................................................................ 7.3 Vasoplegic Syndrome...................................................................................................... 7.4 Postoperative Cardiac Tamponade (POCT) .................................................................... 7.5 CPR After Cardiac Surgery............................................................................................. 7.6 Assist Devices ................................................................................................................. 7.6.1 Intra-Aortic Balloon Pump (IABP) ..................................................................... 7.6.2 Ventricular Assist Device (VAD) ........................................................................ 7.6.3 Extracorporeal Membrane Oxygenation (ECMO).............................................. References ................................................................................................................................
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Abstract
The essential principle in post-cardiac surgical care is ensuring optimal hemodynamic preservation and tissue perfusion through the utilization of continuous hemodynamic monitoring, adequate volume repletion, and, if necessary, use of inotropic agents and/or pressors. Cardiopulmonary resuscitation (CPR) for
M. Foroughi, MD (*) Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran e-mail: [email protected], [email protected] A.H. Conte, MD, MBA Perioperative Transesophageal Echocardiography Education, Division of Cardiothoracic Anesthesiology, Department of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA e-mail: [email protected] A. Dabbagh et al. (eds.), Postoperative Critical Care for Cardiac Surgical Patients, DOI 10.1007/978-3-642-40418-4_7, © Springer-Verlag Berlin Heidelberg 2014
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M. Foroughi and A.H. Conte
cardiac arrest after cardiac surgery is different from cardiac arrest in other settings as its causes are usually reversible with associated improved outcomes. Due to aging of the cardiac surgical population and broader application of interventional cardiologic interventions before admission for cardiac surgery, the
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