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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