Use of warm priming solution in open heart surgery: its effects on hemodynamics and acute inflammation

Perfusion ◽  
2008 ◽  
Vol 23 (2) ◽  
pp. 89-94 ◽  
Author(s):  
M Buyukates ◽  
S Acikgoz ◽  
O Kandemir ◽  
E Aktunc ◽  
E Ceylan ◽  
...  
Keyword(s):  
Inflammatory Markers ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Organ Damage ◽  
Significant Rise ◽  
Open Heart ◽  
Hemodynamic Parameters ◽  
Ephedrine Hydrochloride ◽  
Factor Α

Cardiac surgery causes an acute inflammatory response and organ damage. In this study, for the first time in the literature, we compared the effects of priming solutions at 20°C and 36°C on acute inflammatory markers and hemodynamic parameters. Forty patients were recruited and randomized into two groups, each consisting of 20 participants who underwent elective coronary artery bypass grafting operation. Groups were primed with the same solution at different temperatures. Hemodynamic parameters were recorded. Blood samples were drawn pre-operatively and at the 15th and 60th minutes of aortic cross-clamping and the 24th hour following surgery. Serum pre-albumin, α-1 antitrypsin, and tumor necrosis factor-α levels were determined. The groups were compared statistically. Both of the groups were comparable for mean aortic cross-clamping time and mean time for cardiopulmonary bypass. Mean blood pressure value was significantly lower and the mean amount of ephedrine hydrochloride used was significantly higher in the cold priming group. Spontaneous beating of the heart after removal of aortic cross-clamp significantly was more frequent in the warm priming group. A significant rise was observed in systemic inflammatory markers in the cold priming group. In our study, the lesser amount of ephedrine hydrochloride used and the higher frequency of spontneous beating of the heart in the warm priming group may be considered as improvements in hemodynamic status. Use of warm priming solution also induced a significant improvement in the acute inflammatory markers. We recommend the use of warm priming solution in open heart surgery.

Open heart surgery without homologous blood transfusion and subsequent use of recombinant erythropoietin to treat postoperative anemia

1995 ◽  
Vol 5 (2) ◽  
pp. 118-121 ◽  
Author(s):  
Michael Vogel ◽  
Antje Kirchhoff ◽  
Konrad Bühlmeyer ◽  
François Bourlon
Keyword(s):  
Congenital Heart ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Significant Rise ◽  
Recombinant Erythropoietin ◽  
Open Heart ◽  
Not Given ◽  
Homologous Blood ◽  
Homologous Blood Transfusion ◽  
Subcutaneous Dose

SummaryThe purpose of our study was to assess the effect of administration of erythropoietin on postoperative anemia in patients with congenital heart disease who had undergone open heart surgery without the use of homologous blood. One intravenous and one subcutaneous dose of 300 units of erythropoietin per kg body weight was given to 10 patients at a mean of five (3–8) days after surgery. Another group of 10 patients, who had undergone open heart surgery but were not given erythropoietin postoperatively, were used as controls. There was a significant fall in all patients in hemoglobin from 13.6±1.3 gm/dl prior to surgery to 9.8±1.6 gm/dl after surgery. In patients treated with erythropoietin, there was an immediate significant rise in hemoglobin and hematocrit. Hemoglobin rose by 14% on the seventh day after treatment (the twelfth day after surgery) and by 25% on the tenth day after treatment (the fifteenth day after surgery). It had increased by only 8% 15 days after surgery in the controls. These findings suggest a beneficial effect of administration of recombinant erythropoietin on postoperative anemia in children who had undergone open heart surgery without the use of homologous blood.

scholarly journals Effect of Melatonin on Incidence Rate of Delirium in Elderly Patients Undergoing Open-Heart Surgery without a Pump: A Clinical Trial

2019 ◽  
Author(s):  
Fatemeh Hosseini Kasnavieh ◽  
Hassan Rezaeipandari ◽  
Mehdi Hadadzadeh ◽  
Mahmood Vakili ◽  
Fatemeh Hosseini Biouki
Keyword(s):  
Clinical Trial ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Control Group ◽  
Open Heart

Introduction: Delirium has been considered as the most common cognitive disorder after major surgery. Melatonin therapy is effective in reducing the incidence of delirium after open heart surgery with pain relief mechanism and adjustment of the sleep cycle and the absence of specific side effects. This study was conducted to determine the effectiveness of melatonin on prevention of delirium after coronary artery bypass surgery.   Methods: The double blind randomized controlled clinical trial  recruited 140 patients, equally decided, who underwent  coronary artery bypass surgery in Afshar Hospital, Yazd city, 2016. All participants of the two groups were evaluated for the presence of delirium  on the day of surgery and three days after by the Confusion Assessment Method for ICU (CUM-ICU). Respectively, The intervention and control group received 3 mg melatonin and 3 mg placebo orally before and after the operation. Data were analyzed by Chi-square, T-test, paired t-test and Cochran tests.   Results: The incidence of delirium in the melatonin and the control group was 35.7% and 5.7% on the day of operation, 68.6% and 31.4% three days after the operation, respectively. The results showed that there was a significant difference in the frequency of cognitive test of CAM-ICU on day of surgery and three days after surgery between the two groups (p <0.001).   Conclusion: Despite the efficacy of melatonin therapy in reducing delirium, further studies on the effects of other effective drugs on the treatment of delirium, such as antipsychotics and receptor blockers, should be considered.  

Development and Evaluation of Preoperative Teaching Materials for CABG/Valve Surgery Patients

2019 ◽  
Vol 12 (1) ◽  
pp. 73-92
Author(s):  
Patricia A. McLaughlin
Keyword(s):  
Heart Surgery ◽  
Assessment Tool ◽  
Perioperative Complications ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Valve Surgery ◽  
Open Heart ◽  
Patient Anxiety ◽  
Teaching Materials ◽  
Improvement Project

BackgroundPatients often experience anxiety and feel overwhelmed by the prospect of undergoing open-heart surgery. Randomized controlled trials have found preoperative education materials and counseling to reduce levels of patient anxiety, depression, and perioperative complications following coronary artery bypass grafting (CABG)/valve surgery.ObjectiveThe purposes of this performance improvement project were to develop preoperative teaching materials for cardiac surgery inpatients and evaluate their usability.MethodsExisting CABG/valve teaching materials were evaluated. A new booklet was developed through an iterative process. An expert panel reviewed the final draft using the patient education materials assessment tool for printable materials (PEMAT-P). Patients were surveyed for usability and usefulness.ResultsExpert reviewer results for using the PEMAT-P tool for understandability and actionability were 99% and 100%. Of 62 teaching booklets and patient preparedness questionnaires distributed, N = 11 (17.7%) were returned. Nearly all respondents (90.9%) agreed or strongly agreed for questions related to how well the booklet prepared them for surgery. Likewise, 90.9% of respondents agreed or strongly agreed with statements about design and content of the booklet. The hospital consumer assessment of healthcare providers and systems performance reports from October 1, 2016 to December 31, 2016 showed improvement for discharge information (96.2% from 92.2%), symptom to look for (100% from 94.9%), and care transitions (66.2% from 54.3%).ConclusionsThe development and implementation of evidence-based preoperative teaching materials help patients and families prepare for open-heart surgery and self-care after discharge.Implications for NursingNurses' utilization of preoperative teaching materials improves patient satisfaction, preparedness, and usefulness.

Coronary Artery Bypass Surgery in a Patient with a Functional Single Lung

2005 ◽  
Vol 13 (4) ◽  
pp. 377-379 ◽  
Author(s):  
Levent Yazicioglu ◽  
Atilla Aral ◽  
Ozge Uymaz ◽  
Hakki Akalin
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Heart Surgery ◽  
Operative Mortality ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Postoperative Management ◽  
Open Heart ◽  
Mortality And Morbidity

Destructed lung and pneumonectomy are associated with anatomic and physiologic changes that may interfere with the conduct of subsequent open heart surgery. Here we report a case of an autopneumonectomized patient who required open heart surgery. The preoperative, intraoperative and postoperative management of this patient was unique. Open heart procedures on patients with a single lung can be performed with acceptable operative mortality and morbidity.

scholarly journals Risk and benefits of temporary pacemaker electrodes in adult open-heart surgery—a systematic review

2022 ◽  
Vol 30 (1) ◽  
Author(s):  
Malene S. Enevoldsen ◽  
Per Hostrup Nielsen ◽  
J. Michael Hasenkam
Keyword(s):  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Valve Surgery ◽  
Open Heart ◽  
Temporary Pacing ◽  
Number Of Patients ◽  
Temporary Pacemaker ◽  
Pacemaker Electrodes ◽  
Significant Factors

Abstract Background To assess the achieved risk and benefits of inserting temporary epicardial pacemaker electrodes after open-heart surgery for potential treatment of postoperative cardiac arrhythmias, and to investigate the extent of its use in clinical practice. Main text A systematic search was conducted in PubMed and repeated in Embase and Scopus using the PRISMA guidelines. The search identified 905 studies and resulted in 12 included studies, where the type of surgery, study design, total number of included patients, number of patients having temporary pacemaker electrodes inserted, number of patients requiring temporary pacing, primary reason for pacing, significant factors predicting temporary pacing, registered complications and study conclusion were assessed. Eight papers concluded that routine insertion of temporary pacemaker electrodes in all postoperative patients is unnecessary. One paper concluded that they should always be inserted, while three papers concluded that pacing is useful in the postoperative period, but did not recommend a frequency of which they should be inserted. Conclusions The literature suggests that the subgroup of younger otherwise healthy patients without preoperative arrhythmia having isolated coronary artery bypass grafting surgery or single valve surgery should not routinely have temporary pacemaker electrodes inserted.

scholarly journals Acceptable short-term outcomes after open heart surgery in kidney transplant recipients: a case control study

2019 ◽  
Author(s):  
Bartlomiej Jozef Witczak ◽  
Jan L. Svennevig ◽  
Anders Hartmann ◽  
Arnt E. Fiane ◽  
Anders Åsberg
Keyword(s):  
Risk Factors ◽  
Kidney Transplant ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Transplant Recipients ◽  
Kidney Transplants ◽  
Kidney Transplant Recipients ◽  
Short Term

Abstract Background Cardiovascular disease is common in kidney transplant recipients. They are considered high risk surgery candidates due to comorbidity and immunosuppression. We assessed short-term results of open-heart surgery in kidney transplant recipients and matched controls between 1989 – 2016 at our center. Methods Ninety-five patients underwent open heart surgery (48 coronary artery bypass grafting, 27 valve replacements or repairs and 29 combined procedures) after kidney transplantation. Controls (n=95) were matched for age, sex, type and year of surgery. Mean follow-up was 5.6 (4.9) years. Independent two-sample t-test and chi-square test were used to compare continuous variables and frequencies, respectively. Logistic regression was used to identify preoperative risk factors for 30-day mortality. Results Included were 76 men and 19 women; mean age 60.3 (11.1) years, 7.1 (5.6) years after transplantation. Kidney transplants had lower renal function, more hypertension, but less pulmonary hypertension than matched controls. Intraoperative data was comparable between kidney transplants and controls. Kidney transplants experienced more frequent acute kidney injury (57% versus 23%, p<0.001), more bleeding (1288 (1081) mL versus 957 (548) mL, p=0.01) and more red cell transfusions (4.9 (5.6) versus 3.2 (5.4) units, p=0.04). Infections were borderline more frequent in kidney transplants (30% versus 20%, p=0.10). Thirty-day mortality was 6.3% in kidney transplants and 2.1% in controls (p=0.14). Independent risk factors for 30-day mortality were acute myocardial infarction last 90 days before surgery (OR 12.5, p=0.02) and current smoking (OR 17.3, p=0.02). Conclusions Kidney transplant recipients undergoing cardiac surgery have acceptable short-term results compared with matched controls; 30-day mortality rates were similar. Careful peri- and postoperative management is, however, warranted as kidney transplant recipients experience more bleeding and higher frequency of AKI.

scholarly journals Acceptable short-term outcomes after open heart surgery in kidney transplant recipients: a case control study

2020 ◽  
Author(s):  
Bartlomiej Jozef Witczak ◽  
Jan L. Svennevig ◽  
Anders Hartmann ◽  
Arnt E. Fiane ◽  
Anders Åsberg
Keyword(s):  
Risk Factors ◽  
Kidney Transplant ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Transplant Recipients ◽  
Kidney Transplants ◽  
Kidney Transplant Recipients ◽  
Short Term

Abstract Background Cardiovascular disease is common in kidney transplant recipients. They are considered high risk surgery candidates due to comorbidity and immunosuppression. We assessed short-term results of open-heart surgery in kidney transplant recipients and matched controls between 1989 – 2016 at our center. Methods Ninety-five patients underwent open heart surgery (48 coronary artery bypass grafting, 27 valve replacements or repairs and 29 combined procedures) after kidney transplantation. Controls (n=95) were matched for age, sex, type and year of surgery. Mean follow-up was 5.6 (4.9) years. Independent two-sample t-test and chi-square test were used to compare continuous variables and frequencies, respectively. Logistic regression was used to identify preoperative risk factors for 30-day mortality. Results Included were 76 men and 19 women; mean age 60.3 (11.1) years, 7.1 (5.6) years after transplantation. Kidney transplants had lower renal function, more hypertension, but less pulmonary hypertension than matched controls. Intraoperative data was comparable between kidney transplants and controls. Kidney transplants experienced more frequent acute kidney injury (57% versus 21%, p<0.001), more bleeding (1288 (1081) mL versus 957 (548) mL, p=0.01) and more red cell transfusions (4.9 (5.6) versus 3.2 (5.4) units, p=0.04). Infections were borderline more frequent in kidney transplants (30% versus 20%, p=0.10). Thirty-day mortality was 6.3% in kidney transplants and 2.1% in controls (p=0.14). Independent risk factors for 30-day mortality were acute myocardial infarction last 90 days before surgery (OR 12.5, p=0.02) and current smoking (OR 17.3, p=0.02). Conclusions Kidney transplant recipients undergoing cardiac surgery have acceptable short-term results compared with matched controls; 30-day mortality rates were similar. Careful peri- and postoperative management is, however, warranted as kidney transplant recipients experience more bleeding and higher frequency of AKI.

scholarly journals Referral to and enrolment in cardiac rehabilitation after open-heart surgery in the Netherlands

2021 ◽  
Author(s):  
D. Conijn ◽  
R. A. F. de Lind van Wijngaarden ◽  
H. M. Vermeulen ◽  
T. P. M. Vliet Vlieland ◽  
J. J. L Meesters
Keyword(s):  
Cardiac Rehabilitation ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
University Hospital ◽  
Survey Study ◽  
Open Heart ◽  
Phase 2 ◽  
Medical File ◽  
Professional Guidelines

Abstract Aim Although referral to phase 2 cardiac rehabilitation (CR) following open-heart surgery is recommended in professional guidelines, according to the literature, participation rates are suboptimal. This study investigates the referral and enrolment rates, as well as determinants for these rates, for phase 2 CR following open-heart surgery via sternotomy. Methods A cross-sectional survey study was conducted among patients who underwent open-heart surgery via sternotomy in a university hospital. Data on referral and enrolment rates and possible factors associated with these rates (age, sex, type of surgery, educational level, living status, employment, income, ethnicity) were collected by a questionnaire or from the patient’s medical file. Univariate logistic regression analysis (odds ratio) was used to study associations of patient characteristics with referral and enrolment rates. Results Of the 717 eligible patients, 364 (51%) completed the questionnaire. Their median age was 68 years (interquartile range 61–74) and 82 (23%) were female. Rates for referral to and enrolment in phase 2 CR were 307 (84%) and 315 (87%), respectively. Female sex and older age were independently associated with both non-referral and non-enrolment. Additional factors for non-enrolment were surgery type (coronary artery bypass grafting with valve surgery and miscellaneous types of relatively rare surgery), living alone and below-average income. Conclusion Phase 2 CR referral and enrolment rates for patients following open-heart surgery were well over 80%, suggesting adequate adherence to professional guidelines. During consultation, physicians and specialised nurses should pay more attention to certain patient groups (at risk of non-enrolment females and elderly). In addition, in-depth qualitative research to identify reasons for non-referral and/or non-enrolment is needed.

Fragility—The Price of Renewed Life. Patients Experiences of Open Heart Surgery

2005 ◽  
Vol 4 (4) ◽  
pp. 290-297 ◽  
Author(s):  
Ann-Kristin Karlsson ◽  
Mats Johansson ◽  
Evy Lidell
Keyword(s):  
Health Care ◽  
Heart Surgery ◽  
Family Relations ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Holistic Approach ◽  
Care Staff ◽  
Health Care Staff ◽  
Open Heart ◽  
Fear And Anxiety

Background: Open heart surgery often implies a threat to life and is associated with fear and anxiety. It is also a strong encroachment on body and integrity and adjusting life afterwards could be difficult. Despite improvements in treatment the patients' reactions appear to be unchanged. Introducing a lifeworld perspective would supply a different kind of knowledge based upon the patients' own experiences coloured by their linguistic usage and bodily expressions. Aim: The aim of this study was to describe patients' experiences of open heart surgery in a lifeworld perspective. Method: Fourteen patients treated with coronary artery bypass surgery and/or heart valve operation were in-depth interviewed in 2003. The phenomenological method was used for the interviews as well as for the analysis. The informants reflected on their experiences of the illness, meetings with health care, family relations and wishes for the future. Findings: The essence of the phenomenon was fragility. Fragility was understood through the following categories: distance, uncertainty, vulnerability, reliance and gratitude. Conclusions: Patients want to be treated as unique individuals. They ask for more dialogues with the staff. Awareness of their supposed lifelong fragility implies that health care staff acquires an open and holistic approach.

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