Critical care challenges after vascular surgery

PURPOSE OF REVIEW: Vascular surgical patients represent one of the most complex populations in the intensive care unit, due to a combination of extensive comorbidities and high perioperative risk. Postoperative complications such as major adverse cardiovascular events, acute kidney injury, neurological complications, thromboembolism and coagulopathy are common and often intersect. We present the latest evidence on complications most encountered in critically ill patients exposed to vascular surgery and best practices for their management. RECENT FINDINGS: Although short-term mortality rates for vascular surgical procedures are decreasing, complications continue to be challenging with some procedures incurring higher long-term complication rates. Major adverse cardiovascular events, kidney injury, infections, bleeding, thrombosis and mesenteric ischaemia are some of the most common complications requiring critical care. Optimal management requires early recognition of complications, personalized organ support, and multidisciplinary coordination. SUMMARY: We present an updated, evidence-based overview of management strategies for critically ill vascular surgical patients, with a focus on optimizing perioperative outcomes in this high-risk population. The review highlights best practices in hemodynamic monitoring and addresses the prevention and management of common postoperative complications encountered in critical care.