scholarly journals DOES PREOPERATIVE ANXIETY AFFECT EARLY OUTCOMES OF OPEN-HEART SURGERY?

2021 ◽  
Author(s):  
Zeki Talas ◽  
Muhip Kanko ◽  
Şadan Yavuz Prof ◽  
Sibel Gür ◽  
Burhan Küçük ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Postoperative Complications ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Preoperative Anxiety ◽  
Open Heart ◽  
High Anxiety ◽  
Hamilton Anxiety Scale ◽  
Anxiety Levels ◽  
The Relationship

Aim: We aim to determine the preoperative anxiety levels of patients with open-heart surgery and examine the relationship between anxiety levels and postoperative complications. Material and Methods: In our prospective study, 200 patients who will undergo open-heart surgery preoperative anxiety levels were measured using the Hamilton anxiety scale (HAM-A). Anxiety levels and the development of complications were investigated. Results: Preoperative anxiety was more common in females (p=0.001). The length of stay in the intensive care unit (p=0.006) and the hospital stay (p=0.005) were found to be longer in patients with high anxiety. It was observed that high preoperative anxiety severity increased the risk of developing postoperative complications (p=0.000024). Conclusion: We can say that preoperative anxiety, which is not considered very important, is seen more frequently than expected for patients who will undergo open-heart surgery. In our study, it was observed that high anxiety levels increased the risk of postoperative complications.

scholarly journals Relationship Between Selenium Trace and Patient Outcome After Open-Heart Surgery

2020 ◽  
Vol 10 (4) ◽  
Author(s):  
Gohar Eslami ◽  
Roya Salehi ◽  
Hamidreza Samaee ◽  
Vallialah Habibi ◽  
Mohammad Shokrzadeh ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Heart Surgery ◽  
Acute Stress ◽  
Open Heart Surgery ◽  
Selenium Level ◽  
Serum Selenium ◽  
Open Heart ◽  
Duration Of Surgery ◽  
The Relationship ◽  
Serum Selenium Level

Background: Acute stress response to heart surgery can cause major morbidity in patients. The trace of selenium is useful for preventing heart damage. Although the trend of selenium changes is of high importance for body balance, the usefulness of routine use and effectiveness of this element for patients under open-heart surgery is still unclear. Objectives: This study aimed at assessing serum selenium level before and after open-heart surgery and the relationship between selenium trace and patient outcome. Methods: This prospective analytical study was performed on 100 patients undergoing open-heart surgery using cardiopulmonary bypass (CPB). In all patients, the serum level was measured at a predetermined time (before surgery and one and two days after surgery). Then, the relationship between serum selenium and patient outcome was assessed. Results: The mean serum selenium level in patients on admission was 72.90 ± 14.62 μg/L, one day after surgery was 71.20 ± 15.84 μg/L, and two days after surgery was 71.54 ± 15.97 μg/L. Serum selenium levels were inversely and significantly associated with age (r = -0.183; P = 0.034, 013) duration of surgery (r = -221 and P = 0.014), duration of intensive care unit stay (r = 0.204, P = 0.021), and duration of CPB (r = 0.223, P = 013). Conclusions: Based on this study’s results, a low level of selenium can affect patients’ outcomes after open-heart surgery.

scholarly journals Influence of biomarkers level during follow-up when operating under cardiopulmonary bypass

2015 ◽  
Vol 18 (3) ◽  
pp. 39
Author(s):  
Yu. I. Petrishchev ◽  
A. L. Levit ◽  
I. N. Leyderman
Keyword(s):  
Cardiac Surgery ◽  
Length Of Stay ◽  
Plasma Levels ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Cardiac Surgeons ◽  
The Given ◽  
The Relationship

Systemic inflammatory response was first determined in 1980 and cardiac surgeons turned to it in 1996. At present, there are a lot of publications on this issue, however, the extent of operation and duration of CPB are considered in clinical practice as crucial indicators of severity of patient's condition following cardiac surgery. In our study we tried to look at this problem from a different perspective and draw a parallel between the severity of patient's condition resulting from operational trauma and CPB. We included 48 patients who under-went cardiac surgery under CPB. Plasma levels of procalcitonin (PCT), lactate and interleukin-6 were investigated before the operation, after CPB and at 24 hours. Also revealed was the relationship between the plasma levels of IL-6, lactate and PCT (r = 0.53; p = 0.000 in both cases). The level of PCT at the 3rd stage was found to relate to the duration of CPB (r = 0.4; p = 0.005), ALV (r = 0.44; p = 0.001) and length of stay at ICU (r = 0.53; p = 0.000). We didn't manage to find any relationship between the length of stay at ICU and the duration of CPB. Correlation between the PCT plasma level and the duration of intensive care indicates the importance of dynamics of the given biomarker for early prediction of follow-up course after open-heart surgery.

Cardiothoracic Surgery and Postoperative Intensive Care

2019 ◽  
pp. 417-423
Author(s):  
Juan G. Ripoll Sanz ◽  
Robert A. Ratzlaff
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Patient Care ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Cardiothoracic Surgery ◽  
Open Heart ◽  
Postoperative Intensive Care ◽  
Main Factor

Cardiothoracic surgical (CTS) critical care responsibilities have progressively shifted away from surgeons and toward intensivists in the past several decades. CTS patients present unique challenges, and optimal patient care in the intensive care unit is a main factor for the prevention of deaths after any type of open heart surgery.

Effect of Albumin Addition to Cardiopulmonary Bypass Prime on Outcomes in Children Undergoing Open-Heart Surgery (EACPO Study)—A Randomized Controlled Trial

2020 ◽  
pp. 215013512095908
Author(s):  
Abdul Rauf ◽  
Reena K. Joshi ◽  
Neeraj Aggarwal ◽  
Mridul Agarwal ◽  
Manendra Kumar ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cardiopulmonary Bypass ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Controlled Study ◽  
Risk Category ◽  
Open Heart ◽  
Oncotic Pressure ◽  
Randomized Controlled

Background: There is a paucity of literature regarding the association of high oncotic priming solutions for pediatric cardiopulmonary bypass (CPB) and outcomes, and no consensus exists regarding the composition of optimal CPB priming solution. This study aimed to examine the impact of high oncotic pressure priming by the addition of 20% human albumin on outcomes. Methods: Double-blinded, randomized controlled study was done in the pediatric cardiac intensive care unit of a tertiary care hospital. Consecutive children with congenital heart diseases admitted for open-heart surgery were randomized into two groups, where the study group received an additional 20% albumin to conventional blood prime before CPB initiation. Results: We enrolled 39 children in the high oncotic prime (added albumin) group and 37 children in the conventional prime group. In the first 24-hour postoperative period, children in the albumin group had significantly lower occurrence of hypotension (28.2% vs 54%, P = .02), requirement of fluid boluses (25.6% vs 54%, P = .006), and lactate clearance time (6 vs 9 hours, P < .001). Albumin group also had significantly higher platelet count (×103/µL) at 24 hours (112 vs 91, P = .02). There was no significant difference in intra-CPB hemodynamic parameters and incidence of acute kidney injury. In subgroup analysis based on risk category, significantly decreased intensive care unit stay (4 vs 5 days, P = .04) and hospital stay (5 vs 7 days, P = .002) were found in the albumin group in low-risk category. Conclusion: High oncotic pressure CPB prime using albumin addition might be beneficial over conventional blood prime, and our study does provide a rationale for further studies.

scholarly journals Risk Factors for Candidemia After Open Heart Surgery: Results From a Multicenter Case–Control Study

2020 ◽  
Vol 7 (8) ◽  
Author(s):  
Daniele Roberto Giacobbe ◽  
Antonio Salsano ◽  
Filippo Del Puente ◽  
Ambra Miette ◽  
Antonio Vena ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Heart Surgery ◽  
Case Control Study ◽  
Open Heart Surgery ◽  
Case Control ◽  
Open Heart ◽  
Previous Therapy ◽  
Control Study

Abstract Background Candida species are among the most frequent causative agents of health care–associated bloodstream infections, with mortality &gt;40% in critically ill patients. Specific populations of critically ill patients may present peculiar risk factors related to their reason for intensive care unit admission. The primary objective of the present study was to assess the predictors of candidemia after open heart surgery. Methods This retrospective, matched case–control study was conducted in 8 Italian hospitals from 2009 to 2016. The primary study objective was to assess factors associated with the development of candidemia after open heart surgery. Results Overall, 222 patients (74 cases and 148 controls) were included in the study. Candidemia developed at a median time (interquartile range) of 23 (14–36) days after surgery. In multivariable analysis, independent predictors of candidemia were New York Heart Association class III or IV (odds ratio [OR], 23.81; 95% CI, 5.73–98.95; P &lt; .001), previous therapy with carbapenems (OR, 8.87; 95% CI, 2.57–30.67; P = .001), and previous therapy with fluoroquinolones (OR, 5.73; 95% CI, 1.61–20.41; P = .007). Crude 30-day mortality of candidemia was 53% (39/74). Septic shock was independently associated with mortality in the multivariable model (OR, 5.64; 95% CI, 1.91–16.63; P = .002). No association between prolonged cardiopulmonary bypass time and candidemia was observed in this study. Conclusions Previous broad-spectrum antibiotic therapy and high NYHA class were independent predictors of candidemia in cardiac surgery patients with prolonged postoperative intensive care unit stay.

scholarly journals Open Cardiac Surgery without Blood and Blood Products Transplantation

2017 ◽  
Vol 20 (6) ◽  
pp. 239 ◽  
Author(s):  
Mehmet Kaplan ◽  
Tolga Can ◽  
Anil Karaagac ◽  
Murat Acarel ◽  
Adlan Olsun ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Urine Output ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Morbidity And Mortality ◽  
Open Heart ◽  
Blood Products ◽  
Mortality And Morbidity ◽  
Significant Difference

Background: Blood transfusions are the most common type of tissue and organ transplantation. Perioperative and postoperative transfusions may cause morbidity and mortality and transfusion should based on only hematocrit values but also on hemodynamic and clinical parameters of the patient, which cannot be ignored.Methods: A prospective study was conducted between January 2015 and October 2016 with adult patients undergoing elective open heart surgery. In these patients, a protocol was established, and patients were divided into two groups as transfusion (-) and transfusion (+). In the first 24 hours in the intensive care unit, patients’ drainage, 24-hours urine output, awakening and extubation times, and lactate and bilirubin levels in arterial blood gases were recorded. Thirty-day mortality and morbidity, and hemodynamic and clinical data were compared between these two groups.Results: We have performed a total of 138 cases; no blood and blood products were transfused in 71% (n = 98), and in 29.0% (n = 40) blood and blood products were transfused. Thirty-day mortality and morbidity (arrhythmia, infectious and pulmonary morbidity, myocardial infarction, cerebrovascular accident, renal dysfunction, sternal revision) were compared between these two groups and no statistically significant difference was observed. Patients’ awakening, extubation time, cardiopulmonary bypass period, cross-clamp time, and days in intensive care unit and hospital were compared, and there was no statistically significant difference between the two groups. Conclusion: In this study, we conclude that open heart surgery without blood transfusion may be accomplished with decent peri/postoperative management. The patients who did not receive any blood or blood products were not compromised clinically or hemodynamically. No extra morbidity and mortality were seen in the non-transfusion group. Transfusion decision was based on clinical and hemodynamic parameters such as persistent hypotension or tachycardia, hyperlactatemia, low urine output, and anemic symptoms. 

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