Friday, November 22, 2019
Cardiothoracic Intensive Care Unit (ICU)
Cardiothoracic Intensive Care Unit (ICU) of Razi hospital

Cardiothoracic Intensive Care Unit (ICU):

Introduction

Cardiothoracic Intensive Care Unit was opened in 2007 and untill September 2012, this unit continued its work although it was not at full level activity because of changes occurring on that time; since November 2012, this hospital provided full-time services to patients, actively. In December 2017, this unit was transferred to the specialized Razi Hospital and it has continued his work. Cardiac surgerydepartment located in Razi Hospital and Educational and Research Center has a space of 375 square meters with two operating rooms, 6 ICU beds for adults and children, it has skilled staffs including 2 cardiothoracicsurgeons, cardiac anesthesiologist, nurses, operating room technician, perfusionist, anesthetic technician who are providing services 24 hours a day in adults and children's cardiac surgeryand vascular surgery department.

Different types of surgery:

  • Embolectomy: In the case of acute embolism, which leads to chronical elevation of pulmonary artery pressure, pulmonary endarterectomy is effective toreducepulmonary artery pressure. In the case of acute ambolism, emergency removing clot from artery pressure will be effective. These type of operations are performed in Shahid Rajaee Cardiovascular Center.

  • Coronary Artery Bypass: Coronary artery bypass is a surgical procedure in which a blocked heart vessel or more than one vessels that flow blood to the heart are bypassed;similar arteries or veins from other parts of the bodyare taken to reroute the blood supply around a blocked artery. The blood vessels from other parts of body used as an alternative are as follow: The greatsaphenous vein in leg, blood vessel in chest or blood, radial artery in patient's arm. In fact, these grafts should be attached to a place passing the narrowed coronary artery and then oxygenated blood will flow in it. In fact, this operation aims to get the patient to the normal life, having no pain and it is a precaution against unexpected events including myocardial infarction.

  • Congenital Heart Defect: It is possible to discover this type of illness during the birth or when the patient is infant or a child or a teenager or maybe later than that. There is the possibility of having congenital heart defect without any signs and symptoms, and considering the severity of the illness in the first step and its development in time, the appearance of signs and symptoms may result at any time. Symptoms such as shortness of breath, reduced exercise tolerance are some examples. These illnesses are diagnosed by cardiologist examination, using chest radiography, electrocardiogram, echocardiogram and angiography. In minor illnesses, treatment is not needed, observing the patient by a cardiologist is the only necessary action to be done and in acute illnesses, treatment by the use of medication and surgeries such as anomalous coronary artery repair, are needed. Surgeons in this center are unique in performing some types of surgeries; procedures include aortic valve,ascending aorta, and aortic arch surgeries. More than everyday heart surgery schedule, a cardiovascular surgeonis always present in the hospital for emergency aortic surgeries and he/she is responsible for them.

  • AorticAneurysm: Since some cardiologists work in this hospital, all types of surgeries on aortic valve and peripheral vascular surgeries are operated by their cooperation. These surgeries, specially descending aorta surgery is performed by a team including thecardiovascular surgeon, thoracic surgeons, and thevascular surgeon. Diagnosis, treatment and follow-up treatment procedures for these patients are possible 24 hours a day, using different devices such as echocardiogram, transesophagealechocardiography, CT scanner, angiography and MRI.

  • Heart Valve Repair or Replacement: Heart valves performance is vital to flow blood in a one-way track and they are opened and closed by every heart beats. Changes in pressure on the back or in front of the valve allows the valves to be opened in one side and in appropriate time, then they are closed firmly to prevent backward flow of blood.

  • Replacement of Heart Valve Surgery: There are two common problems in heart valves that need surgery:

    • Narrowing of the valve in the heart: In narrowing of the mitral valve, valve flaps are not opened properly and just a little amount of blood is flowed through the valve. Stenosis is when valve flaps are thick, hard or stick together. Valve surgery is performed to open a narrowed valve or to replace it with a new one

    • Valve Regurgitation: Regurgitation is a condition in which valves are not working properly. In this case, the valve is not moving properly in the right direction forward, so blood leaks backward. A surgery is needed on valve in case of narrowing or the valve should be replaced.

Repairing and replacement of heart valves includes valve reconstruction to make it work properly. Replacing the valve means that the valve is removed and replaced by a biological tissue valve (made from animals or human tissues) or a mechanical valve (made of plastic, carbon or metal).

Installed Equipment in this Ward: Cardiothoracic Intensive Care Unit has special equipment including:

  • Full-option monitoring system

  • 840 Drager Ventilators

  • Echocardiogram capable of doing TEE, TTE Echo-tests

  • intra-aortic balloon pump (IABP)

  • portable radiology equipment privately used in this ward

  • arterial-blood gas (ABG) analyzer or Gasometry device used as a diagnostic tool

  • doing dialysis in ICU; haemodialysis and CRRT in critical conditions

  • a trolley equipped fully and an electroshock device

There is a ward called "Pediatric ICU" which is completely the same as adult ICU. Each bed has a range of equipment including: syringe pump, serum pump, central suction device, blood warmer, foldable beds that can change patient's body position, nebulizer device, ventilator, heart monitoring system, infusion pumps (IMS); hospital air beds, special multi-fold beds that can change patient's body position, nebulizer system, equipment needed for resuscitation. All beds in ICU are connected to the central monitoring system and the beds are separated from each other by an anti-bacterial curtain. There is an isolation room which is equipped with all medical devices according to hospital standards. Power system in ICU is connected to central UPS system of the hospital, so in case of power outage in the city, all devices and equipment work without stopping. There is a CCTV system in this ward for patients to see their family or friends, because “Visiting is forbidden”. So, if the patient has a stable condition, after 48 hours, he/she will be transferred to the Intermediate Care Unit After Cardiac Surgery. Therefore, the number of patients is changeable based on the number of surgeries, the number of patients that have stable condition and lack of patients in acute condition.

2019/09/11
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