Postoperative complications of patients undergoing cardiac surgery

Ball, Lorenzo; Costantino, Federico; Pelosi, Paolo

doi:10.1097/mcc.0000000000000319

Cited by 85 publications

(62 citation statements)

References 67 publications

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“…Atelectasis is one of the most common pulmonary complications encountered following open-heart operations (Ball, Costantino, & Pelosi, 2016;Çağlı, Yıldız, Demirkıran, & Uncu, 2003;Hulzebos et al, 2006;Turkish Thoracic Society, 2014). Since the lungs are not functional and become collapsed throughout the operation, atelectasis might develop as a complication when respiration restarts (Hanözü, 2006;Turkish Thoracic Society, 2014).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Breathing Exercises on Preventing Postoperative Atelectasis: A Randomized Controlled Trial

Devecel¹,

Şenturan²

2018

FNJN

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Aim: This study aims to assess the effect of pre-operative breathing exercises provided to patients undergoing open-heart operation on atelectasis development during the post-operative period. Method: This randomized controlled study was conducted with 48 patients hospitalized for open-heart surgery. Training was provided to the patients in the experimental group in the form of breathing exercises and spirometry and the instructed exercises were performed by the patients for 7 days before the operation. The patients in both groups were assessed in terms of atelectasis during post-operative days. Results: The proportion of atelectasis development on the post-op 0th day was 71% in the experimental group and 92% in the control group. In terms of average peripheral oxygen saturation, the patients in the experimental group had higher oxygen saturation than the patients in the control group (p<0.05). Conclusion: Though not at significant levels, this study found that, performing breathing exercises before the operation decreased atelectasis development, duration of extubation, length of time in intensive care and hospital discharge; thus, pre-operative breathing exercises were found to have a positive effect on patients during the post-operative period.

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Section: Introductionmentioning

confidence: 99%

The Effect of Breathing Exercises on Preventing Postoperative Atelectasis: A Randomized Controlled Trial

Devecel¹,

Şenturan²

2018

FNJN

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“…Kalp ameliyatlarından sonra özellikle Na + , K + , Clbaşta olmak üzere elektrolit değerleri günlük olarak takip edilmelidir. Diüretik alan hastalara gerekli ise K + replasmanı yapılır 13 . Pulmoner arter kateterizasyonu sağ ve sol ventrikül disfonksiyonu arasındaki farkın saptanması, pulmoner hipertansiyon şüphesi veya yüksek riskli kalp cerrahisinde kullanılmaktadır 8 .…”

Section: Hemodinamik Izlemunclassified

“…Kalp kapak ameliyatları sonrası dönemde hemşirelik bakımı oldukça karmaşıktır. Bu ameliyatlar açık kalp cerrahisi tekniğiyle yapıldığından; ameliyatta hipotermi uygulanması, median sternotomi, mekanik protez kapak implantasyonu, göğüs tüpleri, akut dönemde yoğun bakımda mekanik ventilasyona bağlı kalınması odaklanılması gereken ve çeşitli güçlükler yaratan konulardan sadece bir kaçıdır 1,2 . Bu alandaki rehberler genellikle tedavi ilkeleri üzerine yoğunlaşmakta olup, 3,4,5 kalp kapak ameliyatı olan hasta grubunun bakımını tümüyle içeren bir rehbere ulaşılamamıştır.…”

Section: Introductionunclassified

Current Nursing Approaches After Heart Valve Surgery: Why care is important?

Kankaya¹,

Bilik²

2018

BSBD

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Kalp kapak ameliyatları sonrası dönemde hemşirelik bakımı oldukça karmaşıktır. Bu ameliyatlar açık kalp cerrahisi tekniğiyle yapıldığından; ameliyatta hipotermi uygulanması, median sternotomi, mekanik protez kapak implantasyonu, göğüs tüpleri, akut dönemde yoğun bakımda mekanik ventilasyona bağlı kalınması odaklanılması gereken ve çeşitli güçlükler yaratan konulardan sadece bir kaçıdır. Bu alandaki rehberler genellikle tedavi ilkeleri üzerine yoğunlaşmakta olup, kalp kapak ameliyatı olan hasta grubunun bakımını tümüyle içeren bir rehbere ulaşılamamıştır. Açık kalp ameliyatı yöntemiyle kalp kapak ameliyatı uygulanan hastanın bakımına yönelik ülkemizdeki yayın sayısının yetersiz olması, bu derlemenin yazılış amacını oluşturmuştur. Kalp kapak hastalıkları dünyada ve ülkemizde oldukça sık görülmektedir. Bu ameliyatlar hastaların yaşam sürelerini uzatmak ve yaşam kalitelerini artırmak için yapılsa da, çeşitli komplikasyonlara ve istenmeyen durumlara neden olabildikleri için ameliyat sonrası dönemde yakın izlem ve yoğun hemşirelik bakımı gerektirmektedir. Kalp kapak ameliyatları hastaların tüm sistemlerini etkilediğinden, ameliyat öncesi hazırlıktan ameliyat sonrası bakıma kadar olan tüm süreçte hastanın yakından izlenmesi, komplikasyonların erken saptanması ve yönetilmesi açısından önemlidir. Kalp damar cerrahisi hemşireleri, bu özel hasta grubunun bakımında klinik bilgi ve becerilerinin yanı sıra eğitici rollerini aktif bir şekilde kullanabilirler.

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“…Its clinical manifestation ranges from a mild form of respiratory failure up to an acute respiratory distress syndrome (ARDS) requiring prolonged mechanical ventilation (MV) and intensive care unit (ICU) stay [1]. …”

Section: Introductionmentioning

confidence: 99%

Different strategies for mechanical VENTilation during CardioPulmonary Bypass (CPBVENT 2014): study protocol for a randomized controlled trial

Bignami

Guarnieri

Saglietti

et al. 2017

Trials

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BackgroundThere is no consensus on which lung-protective strategies should be used in cardiac surgery patients. Sparse and small randomized clinical and animal trials suggest that maintaining mechanical ventilation during cardiopulmonary bypass is protective on the lungs. Unfortunately, such evidence is weak as it comes from surrogate and minor clinical endpoints mainly limited to elective coronary surgery. According to the available data in the academic literature, an unquestionable standardized strategy of lung protection during cardiopulmonary bypass cannot be recommended. The purpose of the CPBVENT study is to investigate the effectiveness of different strategies of mechanical ventilation during cardiopulmonary bypass on postoperative pulmonary function and complications.Methods/designThe CPBVENT study is a single-blind, multicenter, randomized controlled trial. We are going to enroll 870 patients undergoing elective cardiac surgery with planned use of cardiopulmonary bypass. Patients will be randomized into three groups: (1) no mechanical ventilation during cardiopulmonary bypass, (2) continuous positive airway pressure of 5 cmH2O during cardiopulmonary bypass, (3) respiratory rate of 5 acts/min with a tidal volume of 2–3 ml/Kg of ideal body weight and positive end-expiratory pressure of 3–5 cmH2O during cardiopulmonary bypass. The primary endpoint will be the incidence of a PaO2/FiO2 ratio <200 until the time of discharge from the intensive care unit. The secondary endpoints will be the incidence of postoperative pulmonary complications and 30-day mortality. Patients will be followed-up for 12 months after the date of randomization.DiscussionThe CPBVENT trial will establish whether, and how, different ventilator strategies during cardiopulmonary bypass will have an impact on postoperative pulmonary complications and outcomes of patients undergoing cardiac surgery.Trial registrationClinicalTrials.gov, ID: NCT02090205. Registered on 8 March 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-2008-2) contains supplementary material, which is available to authorized users.

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Postoperative complications of patients undergoing cardiac surgery

Abstract: Cardiac surgery is still at high risk for postoperative complications. The optimal type of anaesthesia, protective mechanical ventilation during and after surgery as well as haemodynamic management with vasoactive and inotropic drugs is still to be determined.

Cited by 85 publications

References 67 publications

The Effect of Breathing Exercises on Preventing Postoperative Atelectasis: A Randomized Controlled Trial

The Effect of Breathing Exercises on Preventing Postoperative Atelectasis: A Randomized Controlled Trial

Current Nursing Approaches After Heart Valve Surgery: Why care is important?

Different strategies for mechanical VENTilation during CardioPulmonary Bypass (CPBVENT 2014): study protocol for a randomized controlled trial

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