Lung volume reduction surgery is performed on a high risk population with an associated mortality of 5-10%. The goal of the operation is to eliminate the most diseased areas of lung to reduce overall lung volume and improve respiratory mechanics
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