A Patient's Guide to Heart Surgery
Recovering in the ICU (Intensive Care Unit)
Waking Up in the ICU
Immediately after your surgery, you will be taken to the intensive care unit (ICU) to recover, where a team of specially trained cardiothoracic nurses will take care of you. Their goal is to help you recover as quickly and safely as possible. Along with your surgeon, members of the cardiothoracic anesthesia, surgical and cardiology teams who took care of you in the operating room will continue to follow your progress in the ICU.
Because the ICU is a busy place, you can expect bright lights and a great deal of activity during the day. Many of the sounds you will hear are made by monitors and different types of equipment. Your medications, including those for pain control, will be given through intravenous (IV) tubes at very controlled rates using pumps.
To help you breathe, an endotracheal tube (breathing tube) was inserted while you were asleep. This tube is connected to a respirator that assists your breathing. Because you will not be able to talk or swallow while this tube is in place, your nurse will anticipate your needs and ask you questions that require only a yes or no answer. Nod your head to say yes, and shake your head to say no. When you are fully awake and breathing on your own, the breathing tube will be removed, and you will be able to talk.
It's normal to feel cold and to shiver for a short while after you arrive in the ICU. Your nurse will give you blankets to keep you warm. It's also normal to wake up feeling thirsty, because of the medications you received before or during the surgery, or because you had nothing to eat or drink before your operation. Despite your thirst, you will be limited in what and how much you may drink while in the ICU.
Although all patients are concerned about the pain they will experience, pain after surgery is not as severe as most patients anticipate. To control your pain, you will be given medication that is injected, given orally or by suppository. While you are in the ICU, pain medications will be given to you as scheduled. While doses are calculated to keep you as comfortable as possible, if the medications affect your breathing and/or blood pressure, your physician may decrease the amount of pain medication given to you.
Coughing and Deep Breathing
As you recover in the ICU, the nurses will monitor your blood pressure, pulse rate and breathing. The endotracheal tube (breathing tube) will continue to help you breathe. To prevent postoperative pneumonia, the nurses and respiratory therapists will periodically remove any secretions that may have settled in your lungs during surgery. As soon as your breathing tube is removed, you should begin using your incentive spirometer, followed by coughing exercises. You should continue these exercises every hour while you are awake when you are transferred to your hospital room.
Movement and Changes in Position
While lying in bed, moving and changing position will help improve blood flow in your legs and remove secretions in your lungs. You can move your feet, wiggle your toes and point your toes up toward your head and then down toward the foot of the bed. Your nurse will help you change positions by turning you from one side to another.
Discharge from the ICU
Your surgeon, anesthesiologist and cardiologist will determine the best time for you to be transferred from the ICU to the Cardiothoracic Unit Floor (CT Unit). Most patients are transferred the day after surgery. If you remain in the ICU for more than a day, your surgeon or a member of your surgery team will explain the specific reasons for the delay. The extra time spent in ICU is often for precautionary reasons and does not indicate any problem.