Management of patients after cardiac surgery

The postoperative care of the patient during removal of CPB is the epitomy of modern clinical medicine. Successful postoperative care speaks to the best of modern medicine, namely, sophisticated technology, utilization of a team of concerned medical and nursing specialists, application of clinical pathways, and continued refinement in the patient care based on the principles of continual quality improvement. This article outlines the disruptions of the patient's physiologic systems by the inflammatory state initiated by CPB as a means of alerting the physician to the physical stresses imposed on their patients. Second, it describes the cardiac and noncardiac complications that might arise as a consequence of these disruptions to allow the physician to be proactive in the therapeutic approach. Finally, we propose treatment schemes based on an understanding of the pathophysiologic consequences of CPB and refined by their repeated application in the clinical arena.