What should I expect in the ICU after open heart surgery?

Your recovery from open heart surgery will begin right after your surgery, during a stay in the intensive care unit (ICU). Within an hour or two, your family will be able to come in for their first visit. Here's what they can expect:

• Equipment and monitors. In the ICU, various sensors and machines constantly check your vital signs (including heart rate, blood pressure, temperature, breathing rate, and oxygen levels). Thin wires (pacing wires) may connect from your chest to a small machine that can pace your heart if it's beating too slowly.
• Grogginess and puffiness. You'll still be a little groggy when your family first sees you -- and you won't be looking your best! You'll look a little swollen or puffy. This is a normal result of the fluids you receive during surgery. This puffiness will gradually go away over the next few days.
• Endotracheal (ET) tube and ventilator. An ET tube is a tube placed through your nose or mouth into your trachea (windpipe). At first, the ET tube used during surgery will remain in place in your throat to help you breathe. The ET tube is attached to a breathing machine called a ventilator. You won't be able to talk while the tube is in place, though your healthcare providers may ask you to communicate by writing on a board or by nodding your head or wiggling your toes.
• Tubes for blood, fluids, and medication. You and your loved ones should expect to see various tubes -- in your neck, arms, and/or legs -- connecting to bags and bottles of fluid. For example, chest tubes may help drain blood from your chest into a canister. Other tubes may deliver fluids and medication to your body through a vein or help monitor your condition.
• Bells and whistles. Monitoring equipment will emit alarms from time to time -- but that doesn't always mean there's an emergency. Often these alarms merely prompt your providers to do routine checks or other tasks.
• Work with a respiratory therapist. After surgery, a respiratory therapist will visit you regularly to assess and help improve your lung function. Your therapist will probably ask you to do exercises such as deep breathing and coughing.
• Support stockings. Shortly after surgery, healthcare providers will outfit you with anti-embolism support stockings to help prevent blood clots, improve circulation, and reduce swelling in your legs.

Over the course of your stay in the ICU -- usually only a day or two -- healthcare providers will gradually remove various monitors and tubes.