Current Status of Adult Post-Cardiac Surgery Critical Care in Saudi Arabia.

ABSTRACT

OBJECTIVE: The field of cardiac surgery in Saudi Arabia has developed significantly over the years, with more advanced procedures being performed for high-risk patients with multiple comorbidities. This poses challenging postoperative management issues requiring multidisciplinary, highly organized expert care in cardiovascular critical care. This survey aimed to describe the current state of postoperative critical care for cardiac surgeries in Saudi Arabia. DESIGN: This e-mail survey developed by the Chapter of Adult Cardiovascular Critical Care of the Saudi Critical Care Society included 61 questions pertaining to the geographic distribution of adult cardiac surgery centers in Saudi Arabia, including what types of operations and how many operations are being performed, and information on intensive care units such as data on staffing, equipment, protocols, and outcome assessment in these units. SETTING: The study was conducted in Saudi Arabia. PARTICIPANTS: Participating physicians included representatives of adult intensive care units in all cardiac centers (N = 42). INTERVENTIONS: There were no interventions in this study. MEASUREMENTS AND MAIN RESULTS: Of the study cardiac centers, 71.4% have specialized cardiovascular critical care units for the postoperative care of cardiac patients and 42.9% are managed in a closed design by expert in-house physicians on a 24-hour basis. The estimated cardiac surgery intensive care unit bed capacity in Saudi Arabia is 7.3 (ranging from 3.0 in Qasim Region to 11.6 in Mecca Region) beds/1 million population, with 1.3 cardiac centers/1 million and 79 centers/1 million cardiovascular surgical patients. Several protocols are implemented in these critical care units with key performance indicators to meet the best quality of care. CONCLUSIONS: Cardiac surgery intensive care units in Saudi Arabia have varying management structures, care practices, and healthcare provider staffing models, although most of the large-volume centers are adopting the intensivist-led team model of care. Guidelines are needed to standardize practice in all cardiac surgery centers regarding processes and protocols, intensive care unit staffing models, and reporting of outcomes and key performance indicators. Further studies are needed to study cardiac surgery intensive care unit factors related to patient outcomes after cardiac surgery.