In the ICU After Heart Surgery: What to Expect

Waking Up

When you start to wake up, you may feel yourself coughing or have a choking feeling. This feeling will pass and the nurses will be on hand to help you relax.

While you are still intubated (on the respirator), we will have you sit up in the bed. You may hear machines pumping and beeping. These alarms and monitors help the nurses and doctors know how awake you are. The tube that is attached to the respirator will be removed when you are wide awake. This can occur anywhere from 6-24 hours following surgery. The doctors and nurses will ask you to squeeze their hands and lift your head off the pillow. This tells us that you can now handle breathing on your own.

Many times restraints are used for safety reasons. You can imagine that a first response upon waking would be to pull at the tube in your throat. Restraints prevent this from occurring.

Once the tube comes out, you will probably be thirsty. You can ask the nurse to wet your lips. You will not be allowed to have a drink right away, but you will over time. You may also have a sore throat or a loss of voice. These were caused by the breathing tube and are only temporary.

Now you can finally fall asleep breathing fully on your own.

In order to prevent lung complications and help you clear your lungs you will receive chest physical therapy. This consists of percussion or clapping on your back followed by deep breathing and coughing. This will be done by your nurse and physical therapist.

It is important at this time to frequently use the incentive spirometer (and continue use at home), a device that will measure your progress in taking deep breaths. You will continue to use the incentive spirometer throughout your hospital stay.

While recovery time varies from person to person, most patients are able to breathe on their own the first day after surgery. At the time the breathing tube is removed, you will be able to drink sips of liquids. Your diet will be progressed to clear fluids when your nurse and doctor feel you are ready. Other foods will be added as your tolerance increases. By the second day after surgery, many patients are eating solid food. Following surgery your body needs more sustenance than usual, so it is important during this period to try to eat a healthy diet and make sure your protein and calorie intake is as high as possible, as recommended by your dietician and doctor.


Good nutrition is essential for healing. While your physician and registered dietitian will plan a diet that is tailored to your special needs, it's up to you to follow these recommendations conscientiously. Don't worry if you are unable to eat everything you are served; just try to eat something at every meal. Let your nurse know if you experience nausea; your health care team may be able to offer some assistance in relieving your discomfort.

Shifts in Weight

Please be aware that there are often significant weight shifts around the time of surgery. You may gain fluid weight before and during the operation, and lose it afterwards.

Post Operatively

Once you are ready (approximately 12-48 hours after surgery), you will be transferred from the Intensive Care Unit (ICU) to the Stepdown Unit or a regular bed on the surgical floor. The Stepdown Unit is a 4 bed unit (female and male mixed). In the Stepdown area you will continue to have a heart monitor. This area is located on 5 Hudson North (5HN). The following day you will be moved to a semi-private room on 5HN. Private rooms are available for a fee and are subject to availability.

Individual patients experience varying degrees of pain and soreness after heart surgery. Your doctor will prescribe either a Pain Controlled Analgesia (PCA) pump in which you are in control of the administration of pain medication or an oral pain medication which you can request every 4 to 6 hours depending on the amount of pain you experience. Please advise your doctor and nurse if the medication is not effective.

When you do your required exercises you can literally cushion the pain caused by breathing and coughing by holding a pillow or the teddy bear provided by the ICU staff firmly against your chest, over the incision. This serves as a splint or brace to reduce movement and pain associated with these activities.

As you are feeling stronger, you will be encouraged to stand up and move around. You will continue deep breathing and coughing exercises to clear your lungs. While they may be uncomfortable, these exercises are essential to prevent complications arising from the build-up of secretions in your lungs.

You will gradually progress from moving about your room with assistance to walking in the halls of 5 Hudson North unaided. Your doctor may recommend that you begin working with a physical therapist who will teach you a program of stretching and progressive walking.


There are numerous opportunities for education during and after your stay that we encourage you and your family to take advantage of:

  • Closed Circuit Television on various heart related topics.
  • Education seminars on discharge planning on 5 Hudson North.
  • Heart of Hearts Support and Education Group (post discharge.)

More Heart Surgery Guides

For more information, call us at (212) 305-2633 or use our appointment request form.