Abstract
Postoperative management of major surgical oncology patients is always challenging in view of patient status and complex surgical interventions. Preoperative clinical status may be affected due to chemotherapy, radiotherapy and impact due to cancer per se. This is compounded by complex, long duration, and extensive surgical interventions. Thus, patients require utmost care for an uneventful outcome after successful surgical interventions. Patients may require intensive monitoring in dedicated unit like intensive care unit (ICU) for optimization of various systems functions affected intraoperatively. Usually in cases of uneventful surgery and airway integrity being maintained, trachea is extubated soon after completion of surgery and requires routine postoperative observation in addition to optimal analgesia. However, a group of patients would require intensive monitoring or postoperative mechanical ventilation support in view of compromised systemic function including airway. Due to limited availability of beds in ICU and limited resources, triage should be done for making decision of shifting the patient to ICU. Although ICU constitutes less than 10% of total hospital beds but more than 20% of hospital expenditure is contributed by ICU. Usually ICU stay is 3–5 times more expensive than general surgical wards.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
Suggested Reading
Arroliga A, Frutos-Vivar F, Hall J, Esteban A, Apezteguía C, Soto L, et al. Use of sedatives and neuromuscular blockers in a cohort of patients receiving mechanical ventilation. Chest. 2005;128:496–506.
Bion JF, Ledingham IM. Sedation in intensive care-a postal survey. Intensive Care Med. 1987;13:215–6.
Schweickert WD, Gehlbach BK, Pohlman AS, Hall JB, Kress JP. Daily interruption of sedative infusions and complications of critical illness in mechanically ventilated patients. Crit Care Med. 2004;32:1272–6.
Woods JC, Mion LC, Connor JT, Viray F, Jahan L, Huber C, et al. Severe agitation among ventilated medical intensive care unit patients: frequency, characteristics and outcomes. Intensive Care Med. 2004;30:1066–72.
Kress JP, Gehlbach B, Lacy M, et al. The long-term psychological effects of daily sedative interruption on critically ill patients. Am J Respir Crit Care Med. 2003;168:1457–61.
Grenvik A. The ICU in the modem hospital. In: Reis MD, Langrehr D, editors. The ICU, a cost-benefit analysis. New York: Elsevier Science; 1986. p. 27–37.
Halpern NA, Bettes L, Greenstein R. Federal and nationwide intensive care units and healthcare costs: 1986-1992. Critical Care Med. 1994;22:2001–7.
Milbrandt EB, Kersten A, Rahim MT, et al. Growth of intensive care unit resource use and its estimated cost in Medicare. Crit Care Med. 2008;36:250410.
Dasta JF, McLaughlin TP, Mody SH, Piech CT. Daily cost of an intensive care unit day: the contribution of mechanical ventilation. Crit Care Med. 2005;33:1266–71.
Hanak BW, Walcott BP, Nahed BV, et al. Post-operative intensive care unit requirements following elective craniotomy. World Neurosurg. 2014;81:165–72.
Tablan OC, Anderson LJ, Besser R, et al. Guidelines for preventing health-care-associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR Recomm Rep. 2004;53(RR-3):1–36.
Drakulovic MB, Torres A, Bauer TT, et al. Supine body position as a risk factor for nosocomial pneumonia in mechanically ventilated patients: a randomised trial. Lancet. 1999;354:1851–8.
Muscedere J, Rewa O, McKechnie K, et al. Subglottic secretion drainage for the prevention of ventilator-associated pneumonia: a systematic review and meta-analysis. Crit Care Med. 2011;39:1985–91.
Genuit T, Bochicchio G, Napolitano LM, et al. Prophylactic chlorhexidine oral rinse decreases ventilator-associated pneumonia in surgical ICU patients. Surg Infect. 2001;2:5–18.
Ostermann ME, Keenan SP, Seiferling RA, et al. Sedation in the intensive care unit: a systematic review. JAMA. 2000;283:1451–9.
Hughes CG, McGrane S, Pandharipande PP. Sedation in the intensive care setting. Clin Pharmacol. 2012;4:53–63.
Banh HL. Management of delirium in adult critically ill patients: an overview. J Pharm Sci. 2012;15:499–509.
MacFie J. Enteral versus parenteral nutrition: the significance of bacterial translocation and gut-barrier function. Nutrition. 2000;16:606–11.
McClave SA, Martindale RG, Vanek VW, The ASPEN Board of Directors and the American College of Critical Care Medicine, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition(ASPEN). J Parenter Enter Nutr. 2009;33:277–366.
Critical Care Nutrition. The Canadian Critical Care PracticeGuidelines. Version current August 2013. Internet: http://criticalcarenutrition.com. Accessed Oct 2014.
Lacy BE, Weiser K. Gastric motility, gastroparesis, and gastric stimulation. Surg Clin North Am. 2005;85:967–87.
Wallace DJ, Angus DC, Barnato AE, et al. Nighttime intensiviststaffing and mortality among critically ill patients. N Engl J Med. 2012;366:2093–101.
McMillen MA, Boucher N, Keith D, et al. Maintaining quality of care 24/7 in a nontrauma surgical intensive care unit. J Trauma Acute Care Surg. 2012;73:202–8.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Gupta, N., Vig, S., Gupta, A. (2021). Critical Care of Postoperative Patient after Major Onco-Surgery: Overview. In: Ray, M.D. (eds) Multidisciplinary Approach to Surgical Oncology Patients. Springer, Singapore. https://doi.org/10.1007/978-981-15-7699-7_16
Download citation
DOI: https://doi.org/10.1007/978-981-15-7699-7_16
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-15-7698-0
Online ISBN: 978-981-15-7699-7
eBook Packages: MedicineMedicine (R0)