Intensive Care Unit Readmission after Elective Coronary Artery Bypass Grafting

2005 ◽  
Vol 13 (4) ◽  
pp. 325-329 ◽  
Author(s):  
Joseph Alex ◽  
Rajesh Shah ◽  
Steven C Griffin ◽  
Alexander RJ Cale ◽  
Michael E Cowen ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Cost Of Care ◽  
Sternal Dehiscence ◽  
Elective Coronary Artery Bypass ◽  
Group B ◽  
Parsonnet Score

Prospective data of 3,120 consecutive patients who had elective coronary artery bypass were analyzed to identify patient profile, cost, outcome and predictors of those readmitted to the intensive care unit. Group A ( n = 3,002) had a single intensive care unit admission and group B ( n = 118) were readmitted within 30 days after surgery. Parsonnet score, EuroSCORE, age, body mass index, chronic obstructive airway disease, peripheral vascular disease, renal dysfunction, unstable angina, congestive cardiac failure, and poor left ventricular function were higher in group B. Bypass and crossclamp times were longer, and the prevalence of inotropic and balloon pump support, arrhythmias, myocardial infarction, re-exploration, blood loss and transfusion, cerebrovascular accident, wound infection, sternal dehiscence, and multisystem failure were higher in group B. Despite a 4-fold increase in cost of care, the mortality rate (32.4%) of patients readmitted to intensive care was 23-times higher than routine patients (1.4%). Crossclamp time > 80 min, Parsonnet score > 10, EuroSCORE > 9, sternal dehiscence, ventricular arrhythmias, and renal failure predicted readmission.

Impact of postoperative hypothermia on outcomes after off-pump coronary artery bypass grafting

2021 ◽  
pp. 021849232110195
Author(s):  
Vasileios Ntinopoulos ◽  
Nestoras Papadopoulos ◽  
Achim Haeussler ◽  
Dragan Odavic ◽  
Patricia Fodor ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Coronary Artery ◽  
Propensity Score ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Off Pump ◽  
Pump Coronary Artery Bypass

Background Even though the physiological derangements caused by hypothermia are well described, there is no consensus about its impact on postoperative outcomes. The aim of this study is to assess the effect of postoperative hypothermia on outcomes after off-pump coronary artery bypass surgery. Methods A total of 1979 patients undergoing isolated off-pump coronary artery bypass surgery in a single center in the period 2007–2018 were classified according to their axillary temperature measurement at intensive care unit admission postoperatively to either hypothermic (<36°C) or normothermic (≥36°C). Between-group differences on baseline characteristics and postoperative outcomes were assessed before and after propensity score matching. Results Data analysis showed that 582 patients (29.4%) were hypothermic (median temperature 35.5°C) and 1397 patients (70.6%) were normothermic (median temperature 36.4°C). Using propensity score matching, 567 patient pairs were created. Patients with hypothermia exhibited a higher rate of postoperative transfusion of at least three red cell concentrate units (14.3% vs 9%, p = 0.005), a longer intubation duration (median duration, 6 vs 5 h, p < 0.0001), and a longer intensive care unit stay (median stay, 1.6 vs 1.3 days, p = 0.008). There was no difference in reoperation for bleeding, renal replacement therapy, infections, and mortality between the two groups. Conclusions Even though associated with a higher blood transfusion requirement and a slightly longer intensive care unit stay, mild postoperative hypothermia was not associated with a higher morbidity and mortality.

scholarly journals Post-operative ventilatory nursing regime of research coronary artery bypass graft patients

1999 ◽  
Vol 4 (4) ◽  
pp. 29-36
Author(s):  
H Potgieter ◽  
H Uys ◽  
W E Nel
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Full Text ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Independent Practitioner

The nurse working in the intensive care unit functions as an independent practitioner under the Nursing Act and arising SANC regulations. OpsommingDie doel van hierdie navorsing is om die invloed van 'n pre-operatiewe bloedgasanalise op die post-operatiewe ventilatoriese verplegingsregime van 'n koronere vatomleidingspasient te bepaal. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

scholarly journals Comparing dexmedetomidine and propofol for sedation and hemodynamic stability in cardio-thoracic intensive care unit for patients following off-pump coronary artery bypass graft surgery

2021 ◽  
Vol 10 (2) ◽  
pp. 153
Author(s):  
Vasant P. Patil ◽  
Jacob Abraham ◽  
Grace M. George
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
P Value ◽  
Analgesic Requirement ◽  
Off Pump ◽  
Pump Coronary Artery Bypass

Background: Most patients in intensive care unit (ICU) require both sedation and analgesia to encourage natural sleep, facilitate assisted ventilation and modulate physiologic response to stress. The ideal sedative after Coronary artery bypass grafting (CABG) should have rapid onset, immediate resolution of both pain and anxiety, promote cardiac and respiratory stability, maintain a reusability during sedation, allow rapid recovery after discontinuation, and attenuate the cardiovascular, neuroendocrine, and inflammatory response. All these properties may improve outcome in cardiac patients after CABG.Methods: Setting-cardiac ICU. A prospective, randomised, single blind study including 60 patients divided into 2 groups. Data collection tools-study proforma and Ramsay sedation scale (RSS). Data analysed using science and statistical packaged (SPSS) version 20, independent sample `t` test, chi-square test, analysis of variance (ANOVA) and p value ≤0.05 was considered statistically significant.Results: Sedation levels and length of stay of patients on ventilator were comparable in both groups, however, analgesic requirement was significantly less in dexmedetomidine group. Dexmedetomidine group showed significantly lower heart rates compared to propofol group.Conclusions: Dexmedetomidine and propofol are safe sedative agents during mechanical ventilation in ICU for patients undergoing off pump coronary artery bypass (OPCAB). There is more than 50% reduction in analgesic requirement and a significant reduction in heart rate in dexmedetomidine sedated patients. 

Propofol versus midazolam for intensive care unit sedation after coronary artery bypass grafting

1994 ◽  
Vol 22 (9) ◽  
pp. 1415-1423 ◽  
Author(s):  
THOMAS L. HIGGINS ◽  
JEAN-PIERRE YARED ◽  
FAWZY G. ESTAFANOUS ◽  
JOSEPH P. COYLE ◽  
HAUMEI K. KO ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

scholarly journals The effects of a tailored postoperative delirium prevention intervention after coronary artery bypass graft: A randomized controlled trial

2021 ◽  
Author(s):  
Mohammad Abbasinia ◽  
Atye Babaii ◽  
Zahra Nadali ◽  
Samaneh Pakzaban ◽  
Mohammad Abbasi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Intensive Care Unit Stay ◽  
Coronary Artery Bypass ◽  
Postoperative Delirium ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Control Group

Background & Aim: Delirium is a frequent complication in patients hospitalized in the intensive care unit following cardiac surgery. This study aimed to assess the effect of a tailored delirium preventive intervention on postoperative delirium and agitation reduction and length of intensive care unit stay in patients who underwent coronary artery bypass graf. Methods & Materials: In this single-blinded, single-center, randomized controlled design, 60 patients from a hospital in Qom, Iran, were randomly allocated to an intervention or a control group. In the control group, patients received routine care. In the intervention group, patients received routine care, a video tutorial, and the Hospital Elder Life Program. Outcomes were measured using the Confusion Assessment Method for the intensive care unit, Richmond Agitation-Sedation Scale, and length of intensive care unit stay in the second and third days after coronary artery bypass graft. Results: There were no significant differences in the rate of delirium episodes and mean scores of RASS between both groups in the second (P=0.301; P=0.125) and third days (P=0.389; P=0.057) after surgery, respectively. However, the mean duration of intensive care unit stays after surgery was significantly lower in the intervention group compared with the control group (P=0.042). Conclusion: This study indicated the tailored delirium prevention intervention could reduce the length of intensive care unit stay. However, the intervention did not reduce postoperative delirium episodes, nor did the intervention improve the RASS scores in the second and third days after coronary artery bypass graft. A future large multicenter trial with long-term follow-up is needed to assess further the effect of such an intervention.

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