Postoperative Critical Care
Some patients are admitted to intensive care after surgery because it was planned that way, not because anything went wrong. Heart disease, lung disease, diabetes or frailty all make the first day after a major operation the riskiest, and it is better watched closely.
- Often planned before the operation
- Continuous monitoring for the first day
- Pain and fluids managed actively
- Step-down to the ward when stable
Stay
1 to 3 days typically
Duration
Continuous monitoring
Anaesthesia
Continued analgesia after surgery
About Postoperative Critical Care
The decision is usually made at the pre-operative assessment, weighing the size of the operation against the patient's heart and lung reserve. Overnight in intensive care allows blood pressure, oxygen, urine output and pain to be managed continuously through the period when they are most likely to go wrong. Most patients move to a ward the next day.
- Usually decided at the pre-operative assessment, not in theatre
- The first 24 hours carry most of the risk
- Being admitted here is a precaution, not a complication
- Most patients step down within a day
Before you read on
Everything here is general information about postoperative critical care. Whether it suits you, and how it would be done in your case, is a decision for your doctor after examining you.
Your consultant's instructions always take precedence over anything written on this page.
When is it recommended?
Situations in which a doctor may suggest postoperative critical care.
- Major abdominal, chest or vascular surgery
- Patients with significant heart or lung disease
- Elderly or frail patients undergoing major surgery
- Long operations with substantial blood loss
- Patients with sleep apnoea or difficult airways
- Surgery in patients with poorly controlled diabetes
Procedure details
The usual sequence, from first consultation through to follow-up.
Planned in advance
At the pre-operative assessment the anaesthetist explains that a bed will be booked, and why it is a precaution.
Arrival from theatre
You arrive drowsy with monitoring, oxygen and possibly drains and a catheter. Family are told when they can visit.
The first night
Blood pressure, oxygen, pain and urine output are managed continuously through the period of highest risk.
Step-down
Once stable, comfortable and breathing well, you move to the surgical ward, usually the following day.
How to prepare
What to sort out before you come in.
- Ask at your pre-operative visit whether intensive care is planned, and why
- Optimise heart, lung and diabetes control before surgery, which materially reduces risk
- Stop smoking as far in advance as possible
- Prepare family for how you will look afterwards, as lines and monitors are expected
- Bring the medication list, as it is continued or adjusted afterwards
Recovery
What to expect afterwards, and roughly when.
- Most patients move to a ward within one to three days
- Drowsiness and mild confusion on the first day are common and usually settle
- Say when pain is not controlled, since it directly affects breathing and mobility
- Sitting up and walking begin as early as it is safe
- Full recovery continues on the ward and at home over several weeks
Why choose Humayun for planned postoperative critical care
The first day after major surgery is when things go wrong, and planning for it beats reacting to it.
- Beds planned at the pre-operative assessment rather than found in an emergency
- Direct handover from the anaesthetic and surgical teams
- Pain managed actively, because it determines breathing and mobility
- The operating surgeon reviewing alongside the intensivist each day
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More in Critical Care
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Emergency Stabilisation
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Multidisciplinary Critical Care
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