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[Carotid endarterectomy: what postoperative care is needed?].

With the introduction of the diagnosis-related groups system (DRGs), hospital cost containment without compromising quality of care is recommended. Carotid endarterectomy is an effective stroke prevention treatment; the need for routine postoperative intensive care unit (ICU) admission is questionable and is herein evaluated. Between January 1994 and November 1995, 68 patients underwent 79 carotid endarterectomies (CEAs), under general anesthesia, and were postoperatively monitored in a post-anesthesia care unit. 13 patients presented postoperative hypertension and 3 arrhythmia, while 5 patients (7.3%) experienced postoperative complications. Only 8 patients (11.7%) were admitted in ICU for treatment of persistent hypertension (3 cases) with continuous vasoactive drug infusion or because of postoperative complications. One patient (1.4%) died of post-CEA hyperperfusion syndrome. The use of a step down unit for monitoring patients undergoing CEAs is safe and cost-effective and also may identify patients requiring ICU admission.

Aged↗
PubMed1991

[Major surgery of the thoracic wall: preoperative preparation, peri-and postoperative care].

Major chest wall surgery causes significant changes in respiratory function during the peri- and postoperative phases. These are predominantly due to lateral position, use of a double lumen endotracheal tube, one-lung anesthesia, loss of functional intrathoracic volume, postoperative pain and local hypoventilation, pulmonary superinfection and right heart dysfunction. In the present short review pathophysiological mechanisms, appropriate monitoring techniques and some therapeutic modalities are discussed.

Combined Modality Therapy↗