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

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 the field of cardiovascular critical. 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 aimed included 61 questions pertaining to the geographic distribution of adult cardiac surgery centers in Saudi Arabia, what types and how many operations are being performed, and information on intensive care units including 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 71.4% of the cardiac centers 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 around the clock. 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/million population, with 1.3 cardiac centers/million and 79 centers/million cardiovascular surgical patients. Several protocols are implemented in these critical care units with key performance indicators (KPI) to meet the best quality of care. Conclusion Cardiac surgery ICUs (CSICU) in Saudi Arabia currently have variable management structures, care practices, and health care providers staffing models, although most of the large volume centers are adopting the intensivist-led team model of care. Guidelines are needed for standardization of practice in all cardiac surgery centers regarding processes and protocols, ICU staffing models, and reporting of outcome and KPIs. Further studies are needed to study CSICU factors related to patients’ outcomes after cardiac surgery.