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Children's Heart Center

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Postoperative Care

Recovery on the Day of Surgery

After surgery, infants and children will return to the intensive care unit (ICU) to be closely monitored during recovery period. The course of every child after surgery is different, but there are some consistent trends.  

Children generally arrive in the ICU on a ventilator with a breathing tube.

  • Children who have "straightforward" surgeries are generally extubated within 24 hours
  • Children who have more complicated surgeries are on the ventilator for days or, in some cases, weeks.

Each child's recovery happens at a different pace. Your child will be kept as comfortable as possible with several different medications, some which relieve pain, and some which relieve anxiety. The staff will also be asking for your input as to how best to soothe and comfort your child. 

Recovery: Days 2-5

While in the pediatric ICU, your child will have their vital signs reviewed and recorded every hour.  The nurses in the PICU are specifically trained to take care of post-operative heart patients.

Depending on your child's surgery, over the next 1-3 days, the chest tubes (drainage tubes) and Foley catheter will be removed. Once your child's blood pressure is stable and he/she is no longer on IV medications for blood pressure control, the arterial monitoring line will be removed.  The central line (long IV) will most likely stay until your child is discharged from the hospital. 

Once recovery criteria have been met, your child will move out of the PICU into the intermediate children's special care unit.

Knowing some of the equipment and terms will help you during your stay in the ICU: 

  • Ventilator: is a machine that helps your child breathe.  While he/she is under anesthesia during the operation, a small, plastic tube is guided into the windpipe and attached to the ventilator, which breathes for your child while he/she is too sleepy to breathe effectively on his/her own. After open heart surgery, some children will benefit from remaining on the ventilator overnight or even longer.  Other children may be removed from the ventilator the same afternoon as surgery.
  • Intubation: placing the plastic breathing tube into the windpipe
  • Extubation: removal of the plastic breathing tube
  • Intravenous (IV) Catheters: small, plastic tubes inserted through the skin into blood vessels to provide IV fluids and important medicines that help your child recover from the operation.
  • Central Line: Central lines are special IV catheters that are placed into a larger vein, which are typically closer to the trunk, or center, of the body. Central lines, versus regular IV's that are in a hand or foot, are used for a variety of reasons.
  • Arterial Line: a specialized IV placed in the wrist or other area of the body where a pulse can be felt, that measures blood pressure continuously during surgery and while your child is in the ICU.
  • Nasogastric (NG) Tube: a small, flexible tube that keeps the stomach drained of acid and gas bubbles that may build up during surgery.
  • Foley Catheter : a small, flexible tube that allows urine to drain out of the bladder and accurately measures how much urine the body makes, which helps determine how well the heart is functioning. After surgery, the heart will be a little weaker than it was before, and, therefore, the body may start to hold onto fluid, causing swelling and puffiness. Diuretics may be given to help the kidneys to remove excess fluid from the body. Urinary catheters are often called "Foley catheters."
  • Chest tube: a drainage tube may be inserted to keep the chest free of blood that would otherwise accumulate after the incision is closed. Bleeding may occur for several hours, or even a few days after surgery.
  • Heart monitor: a machine that constantly displays a picture of your child's heart rhythm, and monitors heart rate, arterial blood pressure, and other values.
  • Open chest: some children with complicated surgeries have the incision left open for one day, or a few days, after surgery. It is most common in neonates (children less than 30 days of age). The open chest is a common precautionary measure which may prevent complications from modest post-operative bleeding or edema (swelling). 

Children's Special Care Unit

Nurses in this unit are trained to manage patients that are moving towards going home. Your child will have vital signs monitored every 4 hours and will still have all intake (drinks/formula/food) and output (diapers/urine/stool) measured and recorded.  Children in the children's special care unit will be allowed to visit the play room and are encouraged to begin their home routines. 

Infants who spent a lot of time on a ventilator, or who were fairly ill while in the ICU, may have trouble feeding initially. These babies may have an oral aversion, in which they may equate something placed in the mouth, such as a pacifier or bottle, with a less pleasant sensation such as being on the ventilator. Some infants are just tired, and need to build their strength up before they will be able to learn to bottle-feed. Strategies used to help infants with nutrition include the following:

  • Supplemental tube feedings:  Feedings given through a small, flexible tube that passes through the nose, down the esophagus, and into the stomach can either supplement or take the place of bottle feedings. Infants who can drink part of their bottle but not all may be fed the remainder through the feeding tube. Infants who are too tired to bottle feed at all may receive their formula or breast milk through the feeding tube alone.
  • High-calorie formula or breast milk:  Special nutritional supplements may be added to formula or pumped breast milk that increase the number of calories in each ounce, thereby allowing your baby to drink less and still consume enough calories to grow.

Contact Us

Pediatric Cardiology Clinic
The University of Texas Health Science Center Professional Building
6410 Fannin, Suite 370
Houston, TX 77030
Phone: (832) 325-6516

Pediatric Cardiovascular Surgery Clinic
The University of Texas Health Science Center Professional Building
6410 Fannin, Suite 950
Houston, TX 77030

Clinic Phone: (832) 325-7234
Nurse Line: (713) 500-7324