The LITFL Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care.
Chylothorax occurs when chyle from the thoracic duct empties into the pleural space. Chyle is a milky white fluid with a high concentration of triglycerides, chylomicrons, and white blood cells. Pseudochylothorax is pleural fluid that mimics true chylous pleural effusion in appearance but lacks the biochemical criteria for chylothorax; usually due to a longstanding pleural effusion
Vasoplegia Post Cardiopulmonary Bypass. Common; results from a bypass-induced SIRS response, but other causes of vasodilation (e.g. drugs, sepsis) can also contribute
Post-Pericardotomy Syndrome = febrile illness secondary to an inflammatory reaction involving the pleura + pericardium.
Pneumonectomy is the surgical removal of an entire lung, performed via thoracotomy
Phrenic nerve palsy post-cardiac surgery can result from multiple mechanisms and can lead to significant morbidity
Oesophageal Perforation. Mechanism: spontaneous (Boerhaave syndrome, deceleration injury); penetrating (intra and extraluminal)
Indications for Adult Cardiac Surgery
Intensive care unit (ICU) after Cardiac Surgery; 3% risk of death
Hypoxaemia post Cardiac Surgery. Management approach would be based on a systematic assessment of the patient using history, examination and review of investigations with regard to the following possible causes.
Hypothermia Post Cardiac Surgery. multi-factorial: residual hypothermia post CPB, failure to rewarm, open thoracic cavity, cold OT, administration of cold fluids
Hypotension Post Cardiac Surgery. Think PROVED?: pump, rhythm, obstruction, volume, (endocrine), distributive, ? = artefactual
Hypertension Post Cardiac Surgery