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Patients undergoing aortic arch surgery are at high risk for stroke, delirium, low cardiac output, respiratory failure, renal failure, and coagulopathy. A significantly higher mortality is seen in patients experiencing any of these complications when compared with those without complications. As surgical, perfusion, and anesthetic techniques improve, the incidence of major complications have decreased. A recent paradigm shift in cardiac surgery has focused on rapid postoperative recovery, and a similar change has affected the care of patients after arch surgery. Nevertheless, a small subset of patients experience significant morbidity and mortality after aortic arch surgery, and rapid identification of any organ dysfunction and appropriate supportive care is critical in these patients. In this article, the current state of postoperative care of the patient after open aortic arch surgery will be reviewed.

Bedside critical care ultrasound has performance similar to traditional tests in diagnosing certain pathologies such as pleural effusion, pericardial effusion, pneumothorax, global cardiac dysfunction, and deep venous thrombosis. In this review article, we will provide an update of ultrasound's performance in assessing other pathologies. Specifically, we will discuss the diagnostic performance of ultrasound in the diagnosis of pulmonary embolism, pulmonary edema, and alveolar collapse; in evaluating readiness for extubation; and in predicting fluid responsiveness. These topics were chosen for their importance in the daily management of critically ill patients. A review of recent studies will show that ultrasound is a promising tool for the intensivist in these clinical settings.

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