ICU · Resuscitation

Postoperative complications in the ICU

Also known as Postoperative care · Post-surgical complications · Postoperative respiratory failure · Anastomotic leak · Myocardial injury after noncardiac surgery (MINS) · Postoperative atrial fibrillation · Surgical site infection · Postoperative delirium · Enhanced Recovery After Surgery (ERAS)

Postoperative ICU patients represent a unique population with specific risks: respiratory complications (atelectasis, pneumonia, pulmonary oedema — 1 cause of postop ICU admission), cardiovascular (myocardial injury after noncardiac surgery [MINS], postoperative atrial fibrillation, heart failure — especially in cardiac and vascular surgery), bleeding/haematoma, infection (wound, anastomotic leak, intra-abdominal abscess), AKI (Kheterpal risk index), delirium, DVT/PE. Prevention: early mobilisation, incentive spirometry, multimodal analgesia (avoid opioids if possible — Enhanced Recovery After Surgery [ERAS]), VTE prophylaxis, glycaemic control, stress-ulcer prophylaxis, normothermia. Key: recognise deterioration EARLY — postop patients can decompensate rapidly. The complications cluster by time: bleeding in the first 24 h, atelectasis day 0-2, AF day 2-4, MINS day 0-3, PE day 3-7, anastomotic leak day 5-7, wound infection day 5-10.