Nursing Care in ICU

  • Michele SanninoEmail author
  • Giulia P. Pisani


At a cardiac intensive care unit, working as a team is very important to guarantee the best possible outcome for the patient. Nowadays nurses are one of the most important members of this team. They have to interact with all healthcare professional who are in charge of taking care of the patient. They have to know the basics of anatomy, physiopathology and surgery of patients with congenital heart disease in order to make the best choices and collaborate actively with the care team. Nurses take part in planning patient care together with the intensivist in both the preoperative and the postoperative period. One of the most important duties of nurses is to be able to assist the intensivist and cardiac surgeon in case of emergency. They are required to have a good understanding of the technologies used to sustain vital functions. The nurse must participate actively in the handover of patients from the operating room after surgery and be able to react appropriately to any problem that may occur and have the best passage of information. A correct nutrition is very important for patients with CHD in both the preoperative and the postoperative period. Choosing the correct type of nutrition and the correct administration is the duty of the nurse. A correct nutritional scheme a correct nutritional scheme is important to guarantee the right calorie intake, which helps achieve a better outcome.


  1. 1.
    Justice L, Ellis M, St George-Hyslop C, Donnellan A, Trauth A, Drouillard B, Watt C, Callow L. Utilizing the PCICS nursing guidelines in managing the CICU patient. World J Pediatr Congenit Heart Surg. 2015;6(4):604–15. Scholar
  2. 2.
    Ofori-Amanfo G, Cheifetz IM. Pediatric postoperative cardiac care. Crit Care Clin. 2013;29:185–202. Scholar
  3. 3.
    Gwinnutt G. Lecture notes clinical anaesthesia. 2nd ed. Oxford: Blackwell Publishing; 2004.Google Scholar
  4. 4.
    Anders M. PICU cardiac guide pediatric cardiac critical care book. 5th ed. 2014. Accessed 2 Jan 2017.
  5. 5.
    Karakaya A, Moerman AT, Peperstraete H, Francois K, Wouters PF, de Hert SG. Implementation of a structured information transfer checklist improves postoperative data transfer after congenital cardiac surgery. Eur J Anaesthesiol. 2013;30:764–9. Scholar
  6. 6.
    Carl M, Alms A, Braun J, Dongas A, Erb J, Goetz A, Goepfert M, Gogarten W, Grosse J, Heller AR, Heringlake M, Kastrup M, Kroener A, Loer SA, Marggraf G, Markewitz A, Reuter D, Schmitt DV, Schirmer U, Wiesenack C, Zwissler B, Spies C. S3 guidelines for intensive care in cardiac surgery patients: hemodynamic monitoring and cardiocirculary system. Ger Med Sci. 2010;8:Doc12. Scholar
  7. 7.
    Sanzo T. Manuale per l’infermiere in terapia intensiva e cardiochirurgia pediatrica. Edizioni del Faro; 2014.Google Scholar
  8. 8.
    Payne L, Zeigler VL, Gillette PC. Acute cardiac arrhythmias following surgery for congenital heart disease: mechanisms, diagnostic tools, and management. Crit Care Nurs Clin North Am. 2011;23:255–72. Scholar
  9. 9.
    Barry P, Morris K, Ali T. Oxford specialist handbooks in paediatrics. Paediatric intensive care. Oxford: Oxford University Press; 2010.CrossRefGoogle Scholar
  10. 10.
    Bigatello LM. Manuale di terapia intensiva del Massachusetts General Hospital. Italian 1st ed. Springer; 2015.Google Scholar
  11. 11.
    Ricci A, Tomasone F. Techniques for detection of the central venous pressure (pvc) and reliability of the measurements. Scenario. 2011;28(2):31–3.Google Scholar
  12. 12.
    ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, Fan E, Camporota L, Slutsky AS. Acute respiratory distress syndrome: the Berlin definition. JAMA. 2012;307(23):2526–33. Scholar
  13. 13.
    Andreoni B, Chiara O, Coen D, Vesconi S. Diagnosi e trattamento delle emergenze medico-chirurgiche. Milan: Elsevier Masson; 2009.Google Scholar
  14. 14.
    Hamm LL, Nakhoul N, Hering-Smith KS. Acid-base homeostasis. Clin J Am Soc Nephrol. 2015;10(12):2232–42. Scholar
  15. 15.
    Koo J, Baxter C, Kellogg K, Mize J, Riley C, Callow L. Guidelines for the general principles of postoperative care: the neonatal and pediatric cardiac surgery patient what the pediatric critical care nurse needs to know. In: The Pediatric Cardiac Intensive Care Society, guidelines. Accessed 12 Dec 2016.
  16. 16.
    Stark FJ, de Leval MR, Tsang VT. Surgery for congenital heart defects. 3rd ed. Chichester: Wiley; 2006.CrossRefGoogle Scholar
  17. 17.
    Kim DJ, Czosnyka Z, Kasprowicz M, Smieleweski P, Baledent O, Guerguerian AM, Pickard JD, Czosnyka M. Continuous monitoring of the Monro-Kellie doctrine: is it possible? J Neurotrauma. 2012;29:1354–63. Scholar
  18. 18.
    Teasdale G. Institute of Neurological Sciences NHS Greater Glasgow and Clyde. Glasgow Coma Scale: do it this way. 2015. Accessed 24 Nov 2016.
  19. 19.
    Christensen B. Adult Glasgow coma scale. 2014. Accessed 24 Nov 2016.
  20. 20.
    Eggenberger ER. Anisocoria clinical presentation. 2016. Accessed 13 Dec 2016.
  21. 21.
    Mutani R, Lopiano L, Durelli L, Mauro A, Chiò A. Il Bergamini di Neurologia. Edizioni libreria Cortina di Torino; 2012.Google Scholar
  22. 22.
    DeSena HC, Nelson DP, Cooper DS. Cardiac intensive care for the neonate and child after cardiac surgery. Curr Opin Cardiol. 2015;30:81–8. Scholar
  23. 23.
    McClave SA, Taylor BE, Martindale RG, Warren MM, Johnson DR, Braunschweig C, McCarthy MS, Davanos E, Rice TW, Cresci GA, Gervasio JM, Sacks GS, Roberts PR, Compher C, Society of Critical Care Medicine, American Society for Parenteral and Enteral Nutrition. 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 (A.S.P.E.N.). JPEN J Parenter Enteral Nutr. 2016;40(2):159–211. Scholar
  24. 24.
    Bankhead R, Boullata J, Brantley S, Corkins M, Guenter P, Krenitsky J, Lyman B, Metheny NA, Mueller C, Robbins S, Wessel J, A.S.P.E.N. Board of Directors. Enteral nutrition practice recommendations. JPEN J Parenter Enteral Nutr. 2009;33(2):122–67. Scholar
  25. 25.
    Thomas DR. Enteral tube nutrition. In: MSD manual professional version. 2015. Accessed 20 Nov 2016.
  26. 26.
    Braegger C, Decsi T, Dias JA, Hartman C, Kolacek S, Koletzko B, Koletzko S, Mihatsch W, Moreno L, Puntis J, Shamir R, Szajewska H, Turck D, van Goudoever J, ESPGHAN Committee on Nutrition. Practical approach to paediatric enteral nutrition: a comment by the ESPGHAN committee on nutrition. J Pediatr Gastroenterol Nutr. 2010;51(1):110–22. Scholar
  27. 27.
    American Society for Parenteral and Enteral Nutrition (ASPEN). What is parenteral nutrition. 2016. Accessed 20 Nov 2016.
  28. 28.
    Thomas DR. Total parenteral nutrition (TPN). In: MSD manual professional version. 2015. Accessed 20 Nov 2016.
  29. 29.
    Boullata JI, Gilbert K, Sacks G, Labossiere RJ, Crill C, Goday P, Kumpf VJ, Mattox TW, Plogsted S, Holcombe B, American Society for Parenteral and Enteral Nutrition. A.S.P.E.N. clinical guidelines: parenteral nutrition ordering, order review, compounding, labeling, and dispensing. JPEN J Parenter Enteral Nutr. 2014;38(3):334–77. Scholar
  30. 30.
    American Society for Parenteral and Enteral Nutrition (ASPEN). Aspen practice tools: critical care toolkit. Algorithms. 2016. Accessed 12 Dec 2016.

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© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Cardiothoracic and Vascular Anesthesia and ICUIRCCS Policlinico San DonatoMilanItaly

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