Manual of Perioperative Care in Adult Cardiac Surgery

Preface ix Acknowledgments xi 1. Synopsis of Adult Cardiac Surgical Disease 1 2. Diagnostic Techniques in Cardiac Surgery 121 3. General Preoperative Considerations and Preparation of the Patient for Surgery 173 4. Cardiac Anesthesia 217 5. Cardiopulmonary Bypass 283 6. Myocardial Protection 323 7. Admission to the ICU and Monitoring Techniques 341 8. Early Postoperative Care 363 9. Mediastinal Bleeding 417 10. Respiratory Management 457 11. Cardiovascular Management 513 12. Fluid Management, Renal, Metabolic, and Endocrine Problems 673 13. Post-ICU Care and Other Complications 737 Appendices 843 Appendix 1A American College of Cardiology Classes of Recommendation and Levels of Evidence 845 Appendix 1B New York Heart Association Functional Classification 845 Appendix 1C The Canadian Cardiovascular Society Classification for Grading of Angina 846 Appendix 1D Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) Profiles of Advanced Heart Failure 847 Appendix 2 Typical Preoperative Order Sheet 848 Appendix 3 Cardiac Surgery Preoperative Assessment Checklist 850 Appendix 4 Typical Orders for Admission to the ICU 851 Appendix 5 Typical Transfer Orders from the ICU 854 Appendix 6 Hyperglycemia Protocol for Cardiac Surgery Patients 857 Appendix 7 Heparinization Protocol for Cardiac Surgery Patients 859 Appendix 8 Protocol for Initiating Warfarin 860 Appendix 9 INR Reversal Protocol 861 Appendix 10A The CHA2DS2-VASc Score 862 Appendix 10B The HAS-BLED Score 863 Appendix 11 Drug, Food, and Dietary Supplement Interactions with Warfarin 864 Appendix 12 Doses of Parenteral Medications Commonly Used in the ICU and Their Modifications in Renal Failure 865 Appendix 13 Doses of Nonparenteral Drugs Commonly Used After Heart Surgery and Their Modifications in Renal Failure 868 Appendix 14 Definitions from the STS Data Specifications (Version 4.20 2020) 874 Appendix 15 Body Surface Area Nomogram 879 Appendix 16 Body Mass Index Chart 880 Appendix 17 Aortic

Robert M. Bojar, MD, Chief of Cardiothoracic Surgery, Saint Vincent Hospital, Worcester, MA, USA