Directed by experienced Cardiac Intensivists, the 10-bed Cardiac Intensive
Care Unit (CICU) is equipped with the latest technology for monitoring
the conditions of children who have undergone cardiothoracic surgery.
These instruments are designed to provide staff with up-to-the-second
information about the child's cardiac status, as well as the status
of other major organ systems.
While the technology may at first seem overwhelming,
parents should feel free to touch and soothe their child. Calm reassurance
and a familiar voice provide comfort that can help to ease a child's
anxiety and promote healing. Parents are also encouraged to bring their
child's favorite toy or security blanket to the CICU.
Due to the affects of anesthesia, children who
have undergone heart surgery need assistance breathing for a period
of time. A tube inserted through the nose or mouth is attached to a
ventilator (breathing machine). Children are not able to talk or cry
with this tube in place. They usually receive medication to relieve
any anxiety and help them relax.
The length of time the ventilator is required is
different for each child and depends largely on the type of surgery
that was performed. For some children it is a matter of a few hours
for others it may be a number of days.
A monitor at the bedside provides important information
about a child's heart rate and rhythm, blood pressure, temperature and
pressures inside the heart. Small adhesive pads on the child's chest
detect the heart rate and rhythm. Special intravenous and arterial catheters
continuously monitor blood pressure and other pressures. Blood for lab
analysis can be obtained from one of these catheters, preventing the
need to draw blood with a needle. Another adhesive pad attached to the
child's finger measures oxygen saturation.
While the child is in the operating room a tube
may be inserted through the mouth or nose into the stomach. This nasogastric
tube helps prevent the child from vomiting and prevents air from collecting
in the stomach, which can cause discomfort. It is usually removed when
the breathing tube is removed.
Some bleeding is normal following a heart operation.
One or more drainage tubes may be inserted in the lower part of the
chest to facilitate the removal of blood. Chest drainage tubes are usually
removed on the second day following surgery and the site is covered
with a bandage.
Many children undergoing heart surgery will have
pacemaker wires attached through their chest. These will be seen taped
to the child's chest and are removed before discharge from the hospital.
A soft tube inserted into the bladder allows exact
measurement of urine. Body temperature is also measured from this catheter
and the value appears on the bedside monitor. Parents may notice on
their first visit after surgery that their child's face, hands or feet
may appear swollen or puffy. This is due to excess fluids that may collect
in the body during surgery. This is a normal occurrence and the fluid
will gradually be eliminated in the urine.
There are two types of chest incisions that a surgeon
may employ when operating on your child. A midline incision extends
down the center of the chest. In contrast, a thoracotomy incision
is located on the side of the chest and extends under the arm. Regardless
of which incision your surgeon employes, at the completion of the
operation the incision is covered with a large bandage that is usually
removed a few days later. If a minimally invasive procedure is chosen,
even smaller incisions in appropriate areas are employed.
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