Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

Today I have from Marko who says, “Hi, Patrik. My fiancé had heart surgery three days ago, heart valve repair. She has not been able to wake up for 3 days. She was transferred to ICU, and they said there’s no brain damage and that she’s breathing on her own, no ventilator. Can you tell me more? Is this a serious situation?”

So, I’m surprised. First of all, if she hasn’t been able to wake up, that she is on a ventilator. But I’m wondering whether this is potentially a typo in your email because most of the time when people can’t wake up after open heart surgery, they do stay on a ventilator until they can wake up. If she’s not waking up, she’s probably at risk of her airway becoming unstable because there’s a risk of aspiration, there’s a risk of airway collapse, but there are probably some other complications here.

I’ve worked in critical care nursing for 25 years in three different countries where I’ve worked as a nurse manager for over 5 years and where I’ve been consulting and for families in intensive care since 2013 at intensivecarehotline.com. I can confidently say we have saved many lives for our clients in intensive care. You can verify that on our testimonial section at intensivecarehotline.com or on our intensivecarehotline.com podcast section where we’ve done client interviews.

So, coming back to Marko’s email, good that she has no brain damage, it’s good that she is breathing on her own. There probably have been some complications of the heart surgery (84), which could include bleeding, would include arrhythmias like the heart has gone into irregular heart rhythm (ECG-electrocardiography), which is actually quite common. She could have had a cardiac tamponade, for example, where there’s bleeding around the heart that could impact the beating function of the heart.

So, there’s so many complications that could happen after cardiac surgery. Also, she might need a temporary pacemaker. She might need some pacing leads. It’s difficult to say from the outset what exactly has happened, but these are certainly complications that I have seen in my many years of intensive care nursing that can happen after open heart surgery or after heart valve repairs.

Other things that could come into consideration when it comes to heart valve repairs or heart valve replacement is the patients after surgery need to go on anticoagulation such as warfarin, and sometimes heparin temporarily. So, these are the complications that I think could have occurred here, but you can take what I said and ask those questions to the intensive care team to see what they are saying.

Most patients after open heart surgery are actually getting out of ICU after one or two days, assuming that heart surgery is going straightforward. But it also sounds to me like heart surgery, in this case, has not been straightforward.