ICU post op setbacks--please advise....

Published

Hello

I am a pre nursing student whose Mom just underwent heart surgery. Her aortic valve was replaced with a pig valve and her tricuspid was reconstructed or revamped without replacing it. The tricuspid valve is still leaking but is much better than it was. The Dr said she was much better off with a small leak than trying to replace it (which isnt done too often). She also had a bypass of the left anterior descending artery. They took a vein from her chest to use for the bypass instead of a leg vein and this will save her from leg discomfort. The Dr said her heart was huge.

The surgery was performed on the 10th. (tonight is the 13th)She is still in the ICU. They took her off ventilator the day after..only to replace it that evening. She has developed a fever of 101. Her BP is dropping ...it is now 100/ 50. Her urine output was poor..so they put her on lasix--so now has improved. Today she is still on ventilator.

Could anyone give me some insight into what I am looking at here? Are these things expected setbacks that many patients have? Should this blood pressure reading set off red flags for me?

I am very worried and hate being so far away from her during this ordeal.

I would really appreciate any input you might have

Thanks

Patty

Up Vote Up Vote ×

Does she have any other history, diabetes, copd, etc?

The cardiomegaly is not good, but it sounds like you had a competent surgeon. Of course dopamine can handle the pressure problems, but the re-intubation is not a good sign. Does she have an underlying breathing problem? Also she may just have very low tolerance to pain if she is not trying hard enough to breath this can be a problem, breathing is sometimes painful post op D/T the incisional pain, they can medicate her so she can breath easier but with her pressures so low they are probably not wanting to sedate her too much(not a problem while on the vent). There is usually some slight variations in B/P post op vessels that have been clogged are now open and flowing well, so it no longer requires the pressure it did pre-op, does that make sense? Things usually stablize in a couple of days.

Good luck with everything. Feel free to psot again for folow up and to let us know how she is doing.

Good luck Larry

Up Vote Up Vote ×

Good luck with everything. Feel free to psot again for folow up and to let us know how she is doing.

Good luck Larry

Hi and thanks Larry. My mother was not in the best of health going in to all of this. She has COPD and congenitive heart failure. She is also overweight. That being said...for the last 1.5 years she has been exercising almost every day (curves) and dieting. She was looking and feeling fantastic. Her stamina was incredible. Before, she wasnt even able to walk up a flight of stairs without needing a break...now she can keep up with all of us walking around for a long time (at the mall etc) The doctors had once said that she wouldnt be a candidate for the surgery because of the underlying health issues...but decided she could handle it now because of her weight loss--increased pulmonary strength, etc.

My sister just called..Said that her BP is 118 now and fever has dropped. This is from tylenol and other meds. She said they are "sucking brown crap" out her lungs--and thinks there is an infection. Her blood count is elevated.

I know you guys cant tell me specifically what this all means or what to expect--I am just hoping for a little insight...or I don't know what I am asking. I JUST HATE being so far away. I am really scared.

Up Vote Up Vote ×

Well the COPD is most likely the reason for the re-intubation sometimes diminished lung capacity has this effect and makes weaning more difficult, she may have a slight pnuemonia which could account for fever as well, they will probably just be less aggressive with weaning and for now the pulmonary toilet (ability to suction secretions from her lungs) will be to her advantage. Presure stabilizing on it's own are are they using a vassopressor? Either way it will likely resolve with time, many times they find the need to D/C previous Antihypertensive meds post-op for the reasons I mentioned earlier about pressure regulation.

You and you family are in my thoughts and prayers. God Bless you and good luck!

Up Vote Up Vote ×
Well the COPD is most likely the reason for the re-intubation sometimes diminished lung capacity has this effect and makes weaning more difficult, she may have a slight pnuemonia which could account for fever as well, they will probably just be less aggressive with weaning and for now the pulmonary toilet (ability to suction secretions from her lungs) will be to her advantage. Presure stabilizing on it's own are are they using a vassopressor? Either way it will likely resolve with time, many times they find the need to D/C previous Antihypertensive meds post-op for the reasons I mentioned earlier about pressure regulation.

You and you family are in my thoughts and prayers. God Bless you and good luck!

wow--you're good! I just got a call that it is slight pnuemonia...Good news is that her fever is gone for almost 24 hours..they are still suctioning...BP is normal and urine output good. She is awake and writing notes. I am worried about the ungs, but it looks like maybe she is rallying! Thanks

Up Vote Up Vote ×

Glad to hear it. I hope everything smoothes out. I guess you are providing long distance information and care? Good Luck and God Bless.

Up Vote Up Vote ×

Any new news? Let me know.

Up Vote Up Vote ×
+ Join the Discussion