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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.
So yesterday, I was talking to a gentleman who had an inquiry about his 63-year-old mom, and she has been in ICU for seven days now. She had one valve replacement and one valve repair, which, from experience, is usually prolonged cardiac surgery. The chest will need to be opened. Often patients end up on a bypass machine or ECMO for a period of time. The lungs are collapsed during that period and when patients come back after this type of surgery, under normal circumstances, if they’re stable, if surgery went well, they usually can be extubated within 24 to 48 hours, assuming they’re hemodynamically stable, assuming there’s no post-operative bleeding, and then they can often be sent to a hospital ward or hospital floor to get on with their recovery.
Now, he’s saying that his mom has been in ICU for seven days and that her recovery is very slow, although she’s off the ventilator. He says she looks very puffy. She’s very slow to recover and for whatever reason, the ICU is still keeping her. Under, again, normal circumstances, this particular lady should be back to the ward. So, there must be some form of complications that he’s not aware of and that I haven’t been able to answer because simply, he doesn’t have enough clinical information, he doesn’t have access to medical records, and we haven’t spoken to doctors and nurses yet.
And that comes back to that the biggest challenge for families in intensive care is simply that they don’t know what they don’t know. They don’t know what to look for. They don’t know what questions ask. They don’t know their rights and they don’t know how to manage doctors and nurses in intensive care. This is exactly what this gentleman is dealing with.
But coming back to his 63-year-old mother after cardiac surgery, so I would assume there must have been some form of complication, maybe irregular heart rhythm, maybe some bleeding, maybe some electrolyte disturbances, post-surgery. Also, maybe some irregular heart rhythm, like atrial fibrillation as a possible cause that they might need to treat in the first place. But he says she’s really slow. She’s very slow to speak. She’s not eating and drinking yet. She seems to be in a lot of pain. And that is another issue after cardiac surgery. Patients have drains in their chest at least for a couple of days or so. They can be very painful on top of the sternotomy. Basically, they cut on the chest.
But if someone is in ICU for seven days off the ventilator but is still not ready to go to a hospital ward, there must be other issues again, such as maybe atrial fibrillation, maybe any other irregular heart rhythm, maybe she still has pacing wires in situ, maybe she’s still paced, as I said, electrolyte disturbances. Also, he says she’s very slow to speak but she is obeying commands. Her brain is intact and that could simply be a slow recovery from all the sedation, all the opiates she had. It’s tough going through ICU after cardiac surgery, especially if there’s sort of a delay in the recovery.
So, that is my quick tip for today.
I hope that helps you understand what should be happening after cardiac surgery. Again, under normal circumstances, patient should be out of ICU within one to two days, and back to cardiac ward or cardiac floor.
Now, if you have a loved one in intensive care, go to intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected].
Also, have a look at our membership for families in intensive care at intensivecaresupport.org. There, you have access to me and my team, 24 hours a day, in a membership area and via email, and we answer all questions intensive care related.
Now, if you need a medical record review for your loved one in intensive care in real time, we can help you with that. We can interpret clinical data in real time while your loved one is in intensive care. And if you need it after intensive care, we can help you with that as well. If you have unanswered questions, if you need closure, or if you are suspecting medical negligence, please contact us as well for a medical record review.
Now, subscribe to my YouTube channel for regular updates for families in intensive care, share the video with your friends and families, click the like button, click the notification bell, and comment below what you want to see next, or what questions and the insights here from this video.
Thanks for watching.
This is Patrik Hutzel from intensivecarehotline.com and I’ll talk to you in a few days.