Managing contractile dysfunction after cardiac surgery

Hemodynamic problems in patients' post cardiac surgery are, in general, complex. Although recovery may be very quick, initial and instant treatment is of high importance to prevent further problems. An intensive care environment with sufficient medical and nurse staffing is best suited to fulfill these requirements. After cardiopulmonary bypass surgery, myocardial stunning is one of the problems encountered, but other contributing factors should be sought, and treatment should be based on the diagnosis. Myocardial stunning can safely be treated pharmacologically with inotropes, and the choice and combination of the inotropic drugs to be used depends on whether additional effects are desired from treatment with vasoactive drugs, if necessary complemented by a mechanical assist device.