What is the role of the ICU in the management of neurologic complications of carotid endarterectomy (CEA)?

Updated: Oct 24, 2019
  • Author: Sonia Nhieu, MD; Chief Editor: Sheela Pai Cole, MD  more...
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Answer

Answer

At some institutions, admission of CEA patients to an intensive care unit (ICU) for close monitoring of hemodynamic status and neurologic function is standard procedure. However, it is unclear whether this resource-intensive practice significantly changes morbidity and mortality; the currently available data are insufficient to predict which patients will benefit from ICU admission.

O'Brien et al found that only a select few patients actually need ICU care after CEA; instead, they recommended observation in a recovery room, followed by admission to an intermediate care unit if the patient remains stable. [11]  To conserve hospital resources, only patients who have a prolonged recovery room course and are hemodynamically or neurologically unstable (states that would usually be evident in the first 2-3 hours after surgery) should be admitted to an ICU.


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