Perioperative Care in Cardiac Anesthesia and Surgery PDF
3.14 MB PDF
Cardiac anesthesia and surgery have evolved over the last five decades since the successful use of cardiopulmonary bypass circuit in 1953. There has been tremendous advancement in the practice of cardiac surgery from deep hypothermia to normothermic or tepid cardiopulmonary bypass regulation, cardioplegia solution, and oxygenators, and so on. Advancement in surgical technique and technology allows progress and ensures success in minimally invasive cardiac surgeries such as off-pump coronary artery bypass, roboticassisted cardiac surgery, valvular surgery, congenital heart disease, and transplantation. Coupled with the advancement of cardiac surgery, cardiac anesthesia has progressed from a high-dose narcotic to a balanced narcotic–inhalational anesthesia using safer and effective anesthetic agents, regional anesthesia, and standard practice of fast-track recovery. There are continuing advancements in perioperative monitoring of myocardial (e.g., transesophageal echocardiography, epiaortic scan) and cerebral (e.g., electroencephalogram, oxygen saturation) conditions, and coagulation.
The modern practice of cardiac anesthesia and surgery has been characterized by cost containment, accountability, and evidence-based medical care. We have responded to these obligations by surgery with the same-day admission program, early tracheal extubation, improved operative techniques, and facilitated rehabilitation, all of which have reduced the intensive care stay and hospital stay.
This practical handbook describes the perioperative management of adult patients who undergo cardiac surgery. Although numerous authors have contributed to the current evidence of perioperative care, each chapter has been carefully edited to reflect the collective view of our cardiac care teams. The purpose of this handbook is to provide a succinct, problem-oriented source of practical information, on the basis of latest clinical and research experience, about patients undergoing cardiac surgery. The appendices section outlines the medical orders, protocols, and guidelines in the management of these patients. These appendices that serve as template examples are currently used in the cardiac surgical programs at Toronto General Hospital and London Health Sciences Centre. This handbook was designed for consultants and trainees in cardiac anesthesia and cardiac surgery, critical care nurses, perfusionists, and other allied health care personnel who are involved in the management of patients undergoing heart surgery.
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