Postoperative care of the CF patient should focus on returning the patient to preoperative baseline status. Care must include aggressive pulmonary toileting to ensure a complete and adequate clearance of secretions. The quicker the patient can increase activity, cough vigorously, take vital capacity breaths, and use an incentive spirometer, the sooner active clearance of pulmonary secretions will occur. The head of the patient’s bed should be elevated to a minimum of 30 degrees to support continued expectoration of secretions. Supplemental oxygen should be humidified for the CF patient.
The CF patient continues to be at risk for pulmonary complications, including respiratory depression, pneumothorax, pneumonia, atelectasis, and obstruction of the airway. If possible, the CF patient should recover in a respiratory ICU instead of a surgical ICU to facilitate the rapid return of full pulmonary function. Close postoperative monitoring is imperative to ensure a full recovery. The CF patient must be continually assessed for proper hydration, airway management, pain control, nutritional requirements, and aggressive pulmonary toileting.
| Element | Target or consideration |
|---|---|
| Secretion clearance | Aggressive pulmonary toileting for complete clearance of secretions |
| Patient activity | Early increase in activity, vigorous coughing, vital capacity breaths and incentive spirometer use |
| Positioning | Head of bed elevated to at least 30 degrees to support expectoration |
| Oxygen | Supplemental oxygen, humidified |
| Recovery location | Respiratory ICU rather than surgical ICU when possible |
| Ongoing assessment | Hydration, airway management, pain control, nutritional requirements and pulmonary toileting |
| Complications to watch | Respiratory depression, pneumothorax, pneumonia, atelectasis and airway obstruction |
