Critical care of the cardiac patient

As the spectrum of cardiac surgeries has grown, the diversity and complexity of postoperative cardiac surgical care has also increased. This article examines 4 areas in critical care where clinical practice is evolving rapidly. Among these are management of mechanical ventilation, thresholds for blood transfusion, strategies for hemodynamic monitoring, and processes for central line insertion. Also reviewed are current approaches to common dilemmas in postoperative cardiac care: diagnosis of tamponade, and the diagnosis and management of low cardiac output states in patients with a ventricular assist device.