postoperative order
- CABG
- infective endocarditis with valve surgery
- aortic dissection with ascending aortic arch replacement
- EVAR
POD | one day | continue |
0 | - 5%DW iv rate 60 ml/hr - morphine - PRC, FFP iv drip as volume - routine la, CXR at ICU |
- NPO - cefazolin 1 g iv q 6 hr x 4 doses - losec 40 mg iv q 12 hr x 2 doses |
1 | - cardipine
|
- regular diet - complete lab + CXR q อ.ศ - aspirin (81) 2x1 o pcเช้า - lasix (40) 1x1 o pc - losec (20) 1x1 o ac - senokot 2 tab o hs - flumucil (100) 1x3 o pc - ativan (1) 1x1 o hs |
2 | - off foley - off drain |
|
3 | - off A-line |
- NTG 0-5 ug/kg/min
- cardipine 0-10 mg/hr
POD | one day | continue |
0 | - 5%DW iv rate 60 ml/hr - morphine - keep SBP 100-120 mmHg - complete lab + CXR at ICU |
- NPO - cefazolin 1 g iv q 6 hr x 4 doses - losec 40 mg iv OD x 2 doses |
1 | - (iv fluid) - cardipine
|
- soft diet - complete lab + CXR q อ.ศ - warfarin (2) 1x1 o hs - lasix (40) 1x1 o pc - losec (20) 1x1 o ac - oral medication |
2 | - iv fluid - off drain |
POD | one day | continue |
0 | - 5%DW iv rate 60 ml/hr - inotrope - morphine - keep SBP 100-130 mmHg - complete lab + CXR at ICU and tomorrow |
- NPO - complete lab + CXR อ, พฤ med - cefazolin 1 g iv q 6 hr x 4 doses - losec 40 mg iv OD x 2 doses |
1 | - (iv fluid) - cardipine
|
- soft diet - complete lab + CXR q อ.ศ - warfarin (2) 1x1 o hs - lasix (40) 1x1 o pc - losec (20) 1x1 o ac - senokot 2 tab o hs - oral medication |
2 | - off foley - off drain |
infective endocarditis with valve surgery
POD | one day | continue |
0 | - 5%DW iv rate 60 ml/hr - inotrope - morphine - keep SBP 100-120 mmHg - complete lab + CXR at ICU |
- NPO - cefazolin 1 g iv q 6 hr x 4 doses - losec 40 mg iv OD x 2 doses |
1 | - (iv fluid) - inotrope
|
- soft diet - complete lab + CXR q อ.ศ - warfarin (2) 1x1 o hs - lasix (40) 1x1 o pc - losec (20) 1x1 o ac - oral medication |
- adrenaline 4 amp + 5%DW 96 ml iv rate 0.05-0.2 ug/kg/min
- levophed 0.02-0.1 ug/kg/min
- dobutamine 0-5 ug/kg/min
aortic dissection with ascending aortic replacement
POD | one day | continue |
0 | - 5%DW iv rate 60 ml/hr - inotrope - morphine - keep SBP 100-130 mmHg - complete lab + CXR at ICU |
- NPO - cefazolin 1 g iv q 6 hr x 4 doses - losec 40 mg iv q 12 hr x 2 doses |
1 | - (iv fluid)
|
- soft diet - complete lab + CXR q อ.ศ - paracetamol - flumucil (100) 1x3 o pc - oral HT drug |
POD | one day | continue |
0 | - 5%DN/2 1000 ml iv rate 60 ml/hr - morphine - tomorrow CBC, BUN, Cr, E'lyte เช้า - tomorrow CXR เช้า |
- NPO - complete lab + CXR q จ, พฤ - cefazolin 1 g iv q 6 hr x 4 doses - losec 40 mg iv q 12 hr x 2 doses - (NAC long 600 mg iv q 12 hr x 4doses) |
1 |
|
- regular diet - simvastatin |
2 | - off A- line |
POD | one day | continue |
0 | - 5%DN/2 1000 ml iv rate 60 ml/hr - morphine - CXR stat - tomorrow CBC, BUN, Cr, E'lyte เช้า - tomorrow CXR เช้า |
- NPO - cefazolin 1 g iv q 6 hr x 4 doses - losec 40 mg iv q 12 hr x 2 doses |
1 |
|
- oral medication |
2 | - off A- line |
POD | one day | continue |
0 | - 5%DN/2 1000 ml iv rate 60 ml/hr - morphine - CXR stat - tomorrow CXR เช้า |
- regular deit - cefazolin 1 g iv q 6 hr x 4 doses - losec 40 mg iv q 12 hr x 2 doses - oral medication |
1 | - triflow - ambulation - off ICD |
|
- cordarone
++ 300 mg iv drip in 4 hr if HR > 130 /min
++ 300 mg iv drip in 6 hr if HR 110-130 /min
++ 300 mg iv drip in 8 hr if HR 90-110 /min
++ 300 mg iv drip in 12 hr if HR 70-90 /min
hold cordarone if HR < 70 /min