Learning Objective #1: Evaluate professional literature that assesses routine ICU admission following carotid endarterectomy.

Learning Objective #2: Analyze this literature regarding predictive preoperative risk factors to determine safe care levels.

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The purpose of this integrated literature review is to determine if Intensive Care Unit (ICU) level of care is necessary for immediate postoperative Carotid Endarterectomy patients. Healthcare institutions are challenged with providing quality evidenced-based care in the midst of skyrocketing costs and nursing shortages. Utilization of higher cost resources such as routine admissions to intensive care units (ICU) post-operatively for specific procedures, such as endarterectomy, accentuates this cost. In today’s culture of evidence based practice, it is necessary to evaluate such routines by evidentiary means. Routine admission to ICU is unnecessary. PACU observation can safely assess appropriate level of care over time and specific preoperative risk factors are not generally predictive of level of care. Further clinical studies are necessary to establish standardized ICU and intermediate care admission criteria along with predictive risk factors for patients undergoing CEA surgery. Cost analysis studies must be done to determine cost effectiveness of PACU observation versus direct ICU admission.