Postoperative critical care management of the congenital heart disease patients

Postoperative care of children with congenital heart disease (CHD) is a complex, multidisciplinary endeavor focused on optimizing cardiac output (CO) and tissue oxygenation when preventing complications such as low CO syndrome (LCOS), pulmonary hypertensive crises, and arrhythmias. This review outlines general principles including structured handovers, targeted hemodynamic and ventilatory support, vigilant monitoring, and early nutrition. It emphasizes lesion-specific management strategies for biventricular and single-ventricle repairs, detailing physiological considerations and surgical implications across CHD types such as tetralogy of Fallot, dextro-transposition of the great arteries, total anomalous pulmonary venous connection, and Fontan. Pharmacologic approaches are aligned with clinical goals like enhancing contractility, reducing afterload, and minimizing oxygen consumption. The article underscores the need for early recognition of deteriorating trends, proactive interventions, and individualized care to improve outcomes in this vulnerable population. Successful postoperative management demands both technical expertise and close team coordination, driven by an understanding of disease-specific pathophysiology and response-based therapy.