Book contents
- Frontmatter
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- SECTION 1 Admission to Critical Care
- 1 Who needs cardiothoracic critical care?
- 2 Scoring systems and prognosis
- 3 Admission to critical care: The cardiology patient
- 4 Admission to critical care: Heart failure
- 5 Admission to critical care: The respiratory patient
- 6 Resuscitation after cardiac surgery
- 7 Transport of the cardiac critical care patient
- SECTION 2 General Considerations in Cardiothoracic Critical Care
- SECTION 3 System Management in Cardiothoracic Critical Care
- SECTION 4 Procedure-Specific Care in Cardiothoracic Critical Care
- SECTION 5 Discharge and Follow-up From Cardiothoracic Critical Care
- SECTION 6 Structure and Organisation in Cardiothoracic Critical Care
- SECTION 7 Ethics, Legal Issues and Research in Cardiothoracic Critical Care
- Appendix Works Cited
- Index
6 - Resuscitation after cardiac surgery
from SECTION 1 - Admission to Critical Care
Published online by Cambridge University Press: 05 July 2014
- Frontmatter
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- SECTION 1 Admission to Critical Care
- 1 Who needs cardiothoracic critical care?
- 2 Scoring systems and prognosis
- 3 Admission to critical care: The cardiology patient
- 4 Admission to critical care: Heart failure
- 5 Admission to critical care: The respiratory patient
- 6 Resuscitation after cardiac surgery
- 7 Transport of the cardiac critical care patient
- SECTION 2 General Considerations in Cardiothoracic Critical Care
- SECTION 3 System Management in Cardiothoracic Critical Care
- SECTION 4 Procedure-Specific Care in Cardiothoracic Critical Care
- SECTION 5 Discharge and Follow-up From Cardiothoracic Critical Care
- SECTION 6 Structure and Organisation in Cardiothoracic Critical Care
- SECTION 7 Ethics, Legal Issues and Research in Cardiothoracic Critical Care
- Appendix Works Cited
- Index
Summary
Introduction
Defibrillation, ventilation, pacing and resuscitation are essential components of cardiac surgical care. The 2005 European Resuscitation Council Guidelines report the incidence of resuscitation as 0.7% in the first 24 hours, rising to 1.4% within the first 8 days of cardiac surgery. Overall in-hospital cardiac surgical mortality rates (>3.0%), together with the low incidence of do not attempt resuscitation (DNAR) orders and the high proportion of treatable arrests in this population all suggest a higher true incidence of postoperative resuscitation. The most likely explanation for the discrepancy is that many resuscitation interventions are undertaken in house on the cardiac surgical critical care. As patients undergoing cardiac surgery become older and sicker, the quality of postoperative care and resuscitation will continue to increase in importance. Conventional advanced life support (ALS) guidelines provide a useful framework but require modification, particularly in the cardiac surgical critical care setting. This chapter highlights some of the key differences.
Resuscitation guidelines
Adult basic life support
Maintaining the circulation has been promoted ahead of airway management and breathing in adult basic life support (BLS) guidelines. The traditional ‘ABC’ (airway, breathing, circulation) in the previous BLS algorithm has been replaced by ‘CAB’ (circulation, airway, breathing). Thirty chest compressions should be given before any attempt to deliver rescue breaths. In situations where BLS is undertaken, the recommended ratio of chest compressions to ventilations is now 30:2 for both one- and two-person cardiopulmonary resuscitation (CPR).
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- Chapter
- Information
- Core Topics in Cardiothoracic Critical Care , pp. 38 - 44Publisher: Cambridge University PressPrint publication year: 2008