Perioperative Care

This chapter summarizes general strategies for the critical care of infants and children undergoing cardiac surgery. Perioperative care ideally involves a multidisciplinary team to facilitate optimal outcomes. Most patients also undergo a routine preoperative screening evaluation that involves a chest x-ray and laboratory testing. Ductal-dependent pulmonary blood flow is present in neonates with severe or complete right ventricular outflow tract obstruction. The electrocardiogram leads should be placed on the chest and limbs so that the patient's heart rate, rhythm, and ST segments can be monitored. Monitoring the patient's oxygen saturation on a continuous basis is the “standard of care” for all infants and children undergoing cardiac surgery. In the current era, the majority of children have an uncomplicated recovery following cardiac surgery. Low cardiac output may occur in up to 25% of newborns within 6–12 hours after surgery.