The cardiovascular surgery intensive care unit is a specialized unit where critical care and monitoring of patients are performed following open-heart surgeries and major vascular surgery operations. Koru Hospital Cardiovascular Surgery Intensive Care Unit provides comprehensive postoperative care services, ranging from life support to hemodynamic stabilization following cardiovascular surgery.
Patient Groups Monitored in CVS Intensive Care
The primary surgical procedures for which postoperative care is provided in the unit are as follows:
- Coronary Artery Bypass Graft (CABG) Surgery: Early hemodynamic monitoring, assessment of graft patency, and management of potential postoperative complications are provided following on-pump and off-pump bypass surgeries.
- Heart Valve Surgery: Anticoagulation management, prosthetic valve function control, and endocarditis prophylaxis are implemented following mechanical or bioprosthetic valve replacement and valve repair operations.
- Aortic Surgery: Intensive hemodynamic monitoring is conducted for patients following aortic aneurysm repair, emergency aortic dissection surgery, and composite graft operations.
- Congenital Heart Surgery: Specialized care protocols are applied following surgical correction operations for adult congenital heart diseases.
- Peripheral Vascular Surgery: Vascular monitoring is performed following carotid endarterectomy, peripheral artery bypass, and endovascular interventions.
Postoperative Care Protocols
The first hours and days following cardiovascular surgery are the critical period when complications are most frequently observed. Our care protocols applied during this process are structured in accordance with international guidelines:
Hemodynamic Stabilization
Continuous hemodynamic monitoring is provided via arterial lines, central venous catheters, and pulmonary artery catheters. Parameters such as cardiac output, systemic vascular resistance, and mixed venous oxygen saturation are monitored in real-time to titrate inotropic and vasopressor therapies.
Respiratory Support and Weaning
The process of safely weaning from mechanical ventilation support after surgery is managed with patient-based protocols. Early tracheostomy evaluation is performed in cases requiring prolonged intubation. Non-invasive mechanical ventilation and high-flow nasal oxygen therapy are used as post-extubation support in appropriate patients.
Bleeding and Coagulation Management
In cases of coagulopathy that may develop after cardiopulmonary bypass, targeted blood product transfusion is performed under the guidance of thromboelastography (TEG). Indications for surgical revision are evaluated in a timely manner through close monitoring of mediastinal drainage volume.
Renal Function and Fluid Balance
Hourly urine output, creatinine kinetics, and fluid balance are meticulously monitored. Continuous renal replacement therapy (CRRT) can be applied in cases where acute kidney injury develops.
Infection Control
Strict infection control protocols are implemented to prevent nosocomial infections such as surgical site infections, mediastinitis, catheter-related bloodstream infections, and ventilator-associated pneumonia. Antibiotic prophylaxis and empirical treatment are regulated according to current guidelines.
Technological Infrastructure
The unit is equipped with advanced life support devices at each bedside, including multi-parameter patient monitors, infusion pumps, mechanical ventilators, and intra-aortic balloon pumps. Extracorporeal membrane oxygenation (ECMO) support can be applied in cases of severe cardiogenic shock and respiratory failure that do not respond to conventional treatment.
Early Mobilization and Rehabilitation
In line with current evidence, early mobilization of hemodynamically stable patients is ensured during the intensive care process. Respiratory exercises and progressive mobilization programs conducted by physiotherapists shorten the length of stay in intensive care and accelerate functional recovery.
Team and Continuity
In the CVS intensive care unit, cardiovascular surgery specialists, anesthesiology and reanimation specialists, intensive care certified nurses, and perfusionists work as a coordinated team. The seamless flow of information between the surgeon who performed the operation and the intensive care team is the fundamental guarantee of patient safety.
Within the Koru Hospital Cardiovascular Surgery Intensive Care Unit, we ensure the safest postoperative recovery process for our patients who have undergone cardiovascular surgery with our expert staff.