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Auckland DHB Cardiothoracic and Vascular Intensive Care and High Dependency Unit

Public Service

Description

The Cardiothoracic and Vascular Intensive Care and High Dependency Units (CVICU and CVHDU) provide intensive care and high dependency care for adult patients (>15 yrs) with all conditions related to heart, lung and blood vessel surgery. Intensive care for liver, kidney, pancreas transplantation and neurological (brain) conditions is provided by the Department of Critical Care Medicine and intensive care for burns is provided by the Middlemore Intensive Care Unit.
The Department is divided into two areas - the Intensive Care Unit where the sickest patients are cared for and the High Dependency Unit where patients who are not well enough to return to the cardiothoracic or vascular wards are treated.


What is the Cardiothoracic and Vascular Intensive Care Unit (CVICU)?

 
CVICU is principally a surgical intensive care unit. The patients are under the care of the Cardiothoracic Intensive Care consultant. Cardiothoracic and Vascular Intensive Care refers to the specialist care given to patients with planned and acute (sudden), potentially reversible, life-threatening cardiac, thoracic or vascular related conditions.


Who is admitted to CVICU?


Patients admitted to CVICU may include the following surgical patients:
a) all patients having coronary bypass or intra-cardiac surgery
b) all patients having aortic arch or thoracic aortic surgery
c) all patients having surgery for ruptured abdominal aortic aneurysms
d) all patients who have had major vascular operations
e) all patients with massive pulmonary embolus
f) all patients who are intubated, and have had either a coronary stent deployed or an intra-aortic balloon pump inserted or both.

All patients should be discussed with the Duty Intensive Care consultant.


Who may be considered for admission to CVICU?


a) Adults having non-bypass operations, usually thoracic or vascular surgery
b) Cardiac or vascular surgical patients requiring readmission from the ward
c) Other adults from the cardiology service
d) Recipients of heart and/or lung transplants requiring intensive care
e) Patients requiring Extra Corporeal Membrane Oxygenation therapy
f) Patients requiring treatment with a Left Ventricular Assist Device.

Patients most likely to benefit from intensive care are those with reversible or potentially reversible life-threatening disorders of vital systems. In deciding whether intensive care is appropriate, the following factors should be considered: the preceding chronic health status and quality of life, physiological reserve and/or biological age, severity of acute illness, probability of reversibility and anticipated disability and quality of life. Some of these factors are often unknown in which case it is commonly appropriate to give the patient the benefit of the doubt.


What is the Cardiothoracic and Vascular High Dependency Unit (CVHDU)?


CVHDU is a cardiothoracic and vascular high dependency unit and admits between 2 and 6 patients per day from Monday to Friday. CVHDU utilises advanced monitoring techniques to care for patients requiring care above the level required for a ward patient but not at the level of care required for an intensive care patient.


Who is admitted to CVHDU?


Patients admitted to CVHDU may include the following:
a) patients who have had thoracotomies (lobectomies, pneumonectomies, WEDGE resections)
b) patients who have had pleurodeses
c) patients who have had thorascopic procedures
d) patients who have had thymectomies
e) patients who have had a mediastinal reopening
f) patients who have had major vascular procedures (e.g. AAA, Fem-Pop bypass, Carotid endarterectomy)
g) patients who have had arterial stenting
h) patients who are occasional ICU step-down patients.


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Consultants

Hours

Cardiothoracic and Vascular Intensive Care and High Dependency Units are both 24 hour/ 7 day services.

Referral Expectations

Patients are rarely admitted directly to the Intensive Care Unit. Patients presenting to hospital are usually admitted via the Emergency Department or other area where they are first stabilised.  Patients whose condition gets worse on the ward, in the operating theatre or presenting from another hospital may be transferred to ICU.
 
What to expect in CVICU and CVHDU
 
Much of the value of the CVICU and CVHDU comes from the careful monitoring of the progress of a disease and the body's response to complex treatments. This allows timely adjustment of such treatments. In order to achieve this, many investigations and monitoring processes will occur. It may be necessary at times to perform complex procedures, which may be time-consuming and require the area to be closed to visitors. 
 
Besides blood tests, monitoring of other body functions is also commonplace. Heart rate, arterial blood pressure, central venous pressure, oxygen saturation and urine output monitoring are routine. Specific conditions may require other investigations such as endoscopic procedures, CT scanning and MRI scanning. The changes are monitored and therapy adjusted as a result of the analysis of the recorded observations.
 
The Department is staffed by a team of highly experienced and professional doctors and nurses who are supported by other healthcare professionals. Medical care is provided by specialist doctors trained to look after very ill patients (Intensivists), and doctors training to be specialists in intensive care, anaesthesia, cardiology and cardiothoracic surgery.
 
Most nurses in intensive care are also specialised with post-graduate training and qualifications in intensive care. Patients requiring intensive care treatment have a nurse allocated to look after them individually. High dependency patients may be cared for by a nurse who is also looking after other patients.
 
CVICU and CVHDU have a team approach and, depending on the patients’ needs, a number of people may be involved in their care.  This includes physiotherapists, dietitians, pharmacists, radiographers, biomedical technicians, social workers, Kaiatawhai and other healthcare professionals.

Procedures / Treatments

  • Blood Tests

    In the ICU blood tests are usually done at least once a day.… More

  • Cardiovascular Problems

    Patients with critical illness commonly develop problems with their hearts and circulation.… More

  • Respiratory Problems

    Respiratory failure occurs when the respiratory system is no longer able to provide enough oxygen requirements or remove enough carbon dioxide from the body.… More

  • Nasogastric Tube

    A nasogastric tube is often inserted at the same time as the endotracheal tube.… More

  • Kidney Problems

    Kidney (or renal) failure is when a patient’s kidneys are unable to remove wastes and excess fluid from the blood.… More

  • Coronary Artery Bypass Surgery (CABG)

    Patients with coronary artery disease can have arteries that are blocked or narrowed, meaning blood flow to parts of the heart is poor or non-existent.… More

  • Heart Valve Surgery

    The heart has four major valves that act like gates to allow blood to flow in the correct direction.… More

  • Congenital Cardiac Surgery

    Congenital heart disease occurs from birth and can include structural defects and heart rhythm problems.… More

  • Aortic Aneurysm Repair

    An aneurysm is a weakness in the wall of a vessel that can cause a large bulging area.… More

  • Transplant Surgery

    Heart or lung transplant surgery can be performed on patients with end stage heart or lung failure with poor life expectancy.… More

  • Extracorporeal Membrane Oxygenation Therapy (ECMO)

    The ECMO machine is similar to the heart-lung bypass machine but it is used outside the operating theatres.… More

  • Ventricular Assist Therapy

    The ventricular assist device (VAD) is a mechanical device that can be used to partially or completely replace the function of a failing heart.… More

  • Wedge Resection

    This involves the removal of a small, localised area of diseased tissue e.g.… More

  • Segmental Resection

    The removal of one or more lung segments (a bronchiole and its aveoli) when the disorder is limited to one or more segments.… More

  • Lobectomy

    Removal of the entire lobe of a lung when there is e.g.… More

  • Pneumonectomy

    Removal of an entire lung, e.g . in the presence of bronchogenic cancer.… More

  • Decortication

    Removal or the stripping off of a thick fibrous membrane (scar tissue) that develops over the visceral pleura.… More

  • Femoropopliteal Bypass

    This operation is to bypass diseased blood vessels above or below the knee.… More

  • Axillofemoral Bypass

    This procedure is performed to relieve lower limb ischaemia (poor blood supply).… More

  • Carotid Endarterectomy

    The carotid artery is opened and plaque/blood clots that are obstructing the blood flow are removed. More

Visiting Hours

Cardiothoracic and Vascular Intensive Care Unit
Visiting allowed between the hours of 9am - 1pm, 3pm - 7pm, 9pm - 11pm, overnight visiting by arrangement. 

Cardiothoracic and Vascular High Dependency Unit
Visiting allowed between the hours of 9am - 1pm, 3pm - 7pm, 9pm - 11pm, overnight visiting by arrangement. 

For Both Areas
Visiting is permitted any time between the hours stated above except during Unit rounds.

Maximum of TWO visitors per patient allowed.

Visiting outside of these hours or over and above the number of allowed visitors can be permitted by prior arrangement with the Shift Coordinator/Charge Nurse.

Contact Details

Auckland City Hospital

Central Auckland

Website: www.adhb.govt.nz/ACHICU

2 Park Road
Grafton
Auckland 1023

View location information

Street Address

2 Park Road
Grafton
Auckland 1023

Postal Address

Private Bag 92 024
Auckland Mail Centre
Auckland 1142

This page was last updated at 3:24PM on October 9, 2014. This information is reviewed and edited by Auckland DHB Cardiothoracic and Vascular Intensive Care and High Dependency Unit.