title: [Surgery in the Cardiovascular Surgical Intensive Care Unit].
abstract: BACKGROUND
  To analyze the indications, actions and results of the operations performed in the Cardiovascular Surgery Intensive Care Unit.
  
  
  METHODS
  Retrospective analysis of consecutive non-selected adult patients operated in the ICU. All operations were included. Descriptive statistics were used.
  
  
  RESULTS
  Between 2008 and 2013, 3379 consecutive adult patients were operated upon. A total of 124 operations were performed in the ICU in 109 patients, 70 male (64.2%) and 39 female (35.8%) with a mean age of 61.6 years (12-80). This represented 3.2% of all operations. During the study period, 185 patients (5.5%) were reoperated for postoperative bleeding/tamponade in the operating room. The index interventions were for valvular heart disease (34.9%), aortic disease (22.9%), ischemic heart disease (15.6%), combined valvular/ischemic (12%), valvular/aorta (11%) and miscellaneous (3.6%). The indications for reoperation were persistent bleeding 54 (43.5%), pericardial tamponade 41 (33%), low cardiac output 13 (10.5%), cardiac arrest/arrhythmia 8 (6.5%), respiratory insufficiency 6 (4.8%) and acute ischemic limb 2 (1.7%). Operations performed were: mediastinal exploration 73 (58.9%), implant/removal of ECMO 17 (13.7%), sternal closure 16 (12.9%), open resuscitation 9 (7.3%), subxyphoid drainage 7 (5.6%) and femoral embolectomy 2 (1.6%). Overall mortality was 33%. There was one case of mediastinitis (0,9%), with no difference from patients operated in the regular operating room.
  
  
  CONCLUSIONS
  Operations in the ICU represent a safe, life-saving alternative in specific subgroups of patients. The risk of wound infection is not increased, unstable patients are not transferred and there is time savings.
authors: Servicio de Cirugía Cardiovascular, Hospital Clínico, Universidad de Barcelona, Barcelona, España.
authors: Juan Fernando
authors: JF
authors: Encalada
authors: Servicio de Cirugía Cardiovascular, Hospital Clínico, Universidad de Barcelona, Barcelona, España.
authors: Paula
authors: P
authors: Campelos
authors: Servicio de Cirugía Cardiovascular, Hospital Clínico, Universidad de Barcelona, Barcelona, España.
authors: Cristian
authors: C
authors: Delgado
authors: Servicio de Cirugía Cardiovascular, Hospital Clínico, Universidad de Barcelona, Barcelona, España.
authors: Guillermo
authors: G
authors: Ventosa
authors: Servicio de Cirugía Cardiovascular, Hospital Clínico, Universidad de Barcelona, Barcelona, España.
authors: Eduard
authors: E
authors: Quintana
authors: Servicio de Cirugía Cardiovascular, Hospital Clínico, Universidad de Barcelona, Barcelona, España.
authors: Elena
authors: E
authors: Sandoval
authors: Servicio de Cirugía Cardiovascular, Hospital Clínico, Universidad de Barcelona, Barcelona, España.
authors: Daniel
authors: D
authors: Pereda
authors: Servicio de Cirugía Cardiovascular, Hospital Clínico, Universidad de Barcelona, Barcelona, España.
authors: Ramón
authors: R
authors: Cartaňá
authors: Servicio de Cirugía Cardiovascular, Hospital Clínico, Universidad de Barcelona, Barcelona, España.
authors: Salvador
authors: S
authors: Ninot
authors: Servicio de Cirugía Cardiovascular, Hospital Clínico, Universidad de Barcelona, Barcelona, España.
authors: Clemente
authors: C
authors: Barriuso
authors: Servicio de Cirugía Cardiovascular, Hospital Clínico, Universidad de Barcelona, Barcelona, España.
authors: Miguel
authors: M
authors: Josa
authors: Servicio de Cirugía Cardiovascular, Hospital Clínico, Universidad de Barcelona, Barcelona, España.
authors: Manuel
authors: M
authors: Castellá
authors: Servicio de Cirugía Cardiovascular, Hospital Clínico, Universidad de Barcelona, Barcelona, España.
authors: José Luis
authors: JL
authors: Pomar
authors: Servicio de Cirugía Cardiovascular, Hospital Clínico, Universidad de Barcelona, Barcelona, España.
authors: Jaime
authors: J
authors: Mulet
authors: Servicio de Cirugía Cardiovascular, Hospital Clínico, Universidad de Barcelona, Barcelona, España. Electronic address: cmestres@clinic.ub.es.
authors: Carlos-Alberto
authors: CA
authors: Mestres
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002648:Child; D003422:Critical Care; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012086:Reoperation; D012189:Retrospective Studies; D055815:Young Adult
keywords: Cardiac; Cardiaca; Cirugía; Cuidados Intensivos; Intensive Care; Intervención; Operation; Surgery