The range of cardiac surgical interventions has greatly increased in recent years. Postoperative management may be difficult due to either the nature of the surgery or to commonly encountered comorbid disease. Cardiorespiratory stability, adequate sedation and analgesia, and vigilant attention to detail are integral factors in the postoperative management of the high-risk cardiac surgical patient.

A further challenge has recently been posed by the recognition that some cardiac surgical patients can be managed with only the briefest period of postoperative ventilation and intensive care. This controversial 'fast-track' approach, driven substantially by resource considerations, is gaining momentum and is likely to be much more widely applied in the future.

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