Caring for Children After Heart Surgery

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Medical Video: Preventing developmental delays in babies after heart surgery

After undergoing surgery, the child will be transferred to the Intensive Care Unit (ICU). Experienced doctors, nurses and technicians will provide care throughout the day for your child.

Don't worry about all the equipment and tubes. The nurse or doctor will explain the purpose of using the monitor, other tools and medications your child needs. Each is needed to help your child and is only used as long as needed.

The doctor may do a blood test, electrocardiogram, echocardiogram and chest x-ray to monitor the child's heart function. The child will also be injected with medication into his veins to increase blood pressure or heart rate or to make the body remove the fluid formed during open heart surgery. Children will fall asleep as comfortably as possible with painkillers and tranquilizers.

Some types of monitoring and support commonly used in ICUs include:

  • Central vein (CVL, CVP or right atrial pathway): A small tube called a catheter that is used to provide medicines, fluids and to monitor the pressure in a child's blood vessels. The tube is placed directly into the heart through the chest or through one of the large blood vessels in the body.
  • Arterial line (line Art): A catheter that measures a child's blood pressure continuously. Tubes are generally placed in the arteries of the wrist, groin or legs.
  • Arterial Blood Gas (ABG): This test is done by taking a blood sample from the arterial line that shows how well the lungs and heart are working.
  • Oxygen Saturation (Sat monitor): A small monitor that attaches to the fingers or toes that allows the oxygen level in the arteries to be monitored continuously.
  • Mechanical ventilator (breathing machine): Most children need this device to deliver oxygen to the lungs until they wake up from surgery and can breathe normally. Ventilators provide oxygen to the lungs through special tubes called endotrachial tubes that are placed in the respiratory tract.
  • Continuous Positive Airway Pressure (CPAP): This special device is placed in your child's nostrils to provide oxygen under pressure. This can keep the lungs wide without using a mechanical ventilator.
  • Nasal canulla: A small tube is placed into the child's nostrils that channel oxygen to the lungs.
  • Chest tube: A tube is placed through a small incision in the chest into the space around the heart or lungs to drain fluid and air produced through surgery. Chances are the child will be given several chest tubes. The doctor will lift the tube when air and fluid are gone.
  • Foley catheter: A tube is placed into the bladder to drain urine continuously and ensures the kid's kidneys are working properly.
  • Interlocking cables: small cables are placed through the chest and attached directly to the heart. If the child's heart is irregularly rhythmic, this cable can be used to restore a normal heart rhythm.

Advanced hospital care

After leaving the ICU, the child will be moved to an area that is not very intensive in the hospital, usually called a "step-down unit". In this room, the medical team will monitor a child's heart rate and rhythm using a continuous electrocardiogram system called telemetry. You can treat your child more often and maybe you can spend the night in one room with your child. The doctor will give a program to the child so that he coughs and breathes deeply, in an effort to prevent infection and pulmonary failure. Encouraging your child to do physical activities, such as playing, walking and going to the bathroom will speed up the child's recovery process.

After surgery, children must eat low-salt foods to reduce the buildup of fluid in the body. Doctors will also prescribe medications such as diuretics, digoxin or antibiotics. Your child may need to take these medicines for some time after returning from the hospital.

Some children experience fever during the first few days after surgery. Fever is a normal postoperative reaction, but if the fever does not go away, the doctor will be tested to find out the cause and how to treat it.

At first, your child needs painkillers, but the pain usually goes away a few days after surgery in most children.

As the child's health returns after heart surgery, body temperature also returns to normal, appetite increases and there are no signs of fluid accumulating in the body, children can take the medicine rather than by injection. The doctor will also stop the supply of oxygen and remove all the equipment attached to the child's body.

When doctors state that your child is better, that means the child can go home. The doctor may do a chest x-ray, echocardiogram and electrocardiogram before the results of the surgery are removed. The doctor will also prescribe painkillers or heart medications. You will be given instructions on how and when to give medicines; make sure you understand the instructions before leaving the hospital. The cardiologist or pediatric surgeon will stop or adjust the drug dosage of the child during the return visit after surgery.

Caring for children at home

The surgical team will provide guidance on wound care and the level of activity for children after being discharged from the hospital. Usually, the incision in the chest must be kept clean and dry. Generally, children are allowed to take a shower or sponge in a short time and dry it with a soft towel, especially in the incision. Swimming or soaking in a bathtub is not allowed for at least a few weeks after surgery. Children can participate in activities at home, but they must avoid strenuous activities, tiring play or sports until the doctor gives permission.

School-age children usually stay at home and get permission from school for a few weeks after surgery. The doctor will tell when the child can return to school and take part in class and sports activities.

You should contact a surgeon or cardiologist if the child has a fever, chest pain, difficulty breathing, or redness, swelling of pus in the incision.

Please consult a doctor if you have questions or problems.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Caring for Children After Heart Surgery
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