Current trends in preoperative, intraoperative, and postoperative care of the adult cardiac surgery patient

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“…A large series of transplanted patients demonstrated an overall incidence of acute kidney dysfunction (acute kidney dysfunction involves all kind of acute problems related to kidney including AKI; this explanation is also for LJS21, 22, and 27) ranging from 6% to 70.4%, based on different inclusion criteria. 4,5,7 The KDIGO criteria have standardized the diagnosis of acute kidney dysfunction and created a staging system that ranges from minor changes in renal function to requirement for renal replacement therapy; these criteria have been adopted by clinicians caring for cardiac surgery patients. By applying these criteria carefully after OCT, and watching for any changes in the patient's status, morbidity and mortality due to AKI can be diminished.…”

“…2,3 Orthotopic cardiac transplant recipients are vulnerable to developing acute kidney dysfunction. [3][4][5] The incidence of acute kidney dysfunction after OCT ranges from 6.0% to 70.4% of patients, of whom 28% to 85% require renal replacement therapy. These patients have a higher mortality rate of ≤ 50% and are at increased risk for developing end-stage renal disease.…”

Who should be responsible from cardiac surgery intensive care? From the perspective of a cardiac anesthesiologist/intensive care specialist

“…[12] Currently, early recovery is preferred for the patient comfort and effective use of the resources of ICU. [22] The use of protective peri-and postoperative ventilation strategies with new ventilator operating modes and increasing disposal of ultrasonographic imaging studies of the lungs by anesthesiologists/ intensivists for early diagnosis are critical landmarks of advancements to reduce respiratory complications in the ICUs.…”

“…[10,11] Given the latest situation in the United States, postoperative care providers in cardiac surgery patients comprised of heart surgeons, anesthesiologists, ICU specialists who received surgical or medical training, residents or acute care nurses, and residents of general surgery, medical intensive care, anesthesia or emergency medicine. [12] Adult and pediatric cardiologists are also one of the most important parts of the ICU team, particularly for close follow-up for patients with hemodynamic instability following complex pediatric cardiac surgery.…”

Shock Management for Cardio-surgical Intensive Care Unit Patient: The Silver Days

“…[57][58][59][60][61] The acute kidney injury network (AKIN) and risk, injury, failure, loss (RIFLE) criteria of AKI are accurate and early predictive of mortality with creatinine levels being the most useful marker. 57,59,62,63 The pathophysiology is complex and involves pre-, intra-and post-operative risk factors.…”