Risk Factors and Prevention Measures for Postoperative Sternomediastinitis (Literature Review)

Author(s):  
A.A. Shevchenko ◽  
◽  
N.G. Zhila ◽  
E.A. Kashkarov ◽  
K.S. Shevchenko ◽  
...  

Median sternotomy remains the most common access in cardiac surgery, while postoperative sternomediastinitis is one of the most severe complications of the transsternal approach. The article analyzes the preoperative risk factors for the development of this complication, including concomitant pathology, constitutional features, bad habits, length of hospital stay, and the urgency of the operation. It was also noted that intraoperative risk factors consist of technical errors in the performance of the operation, intraoperative features of the course of surgery, the nature of the choice of the shunt during myocardial vascularization and the final stage of the operation. Postoperative risk factors include the specific management of the postoperative period in cardiac surgery patients, which can lead to the development of sternomediastinitis. The analysis of measures taken by cardiac surgeons to prevent the development of this complication was carried out

Median sternotomy remains the most frequent access in cardiac surgery, while postoperative sternomediastinitis is one of the most serious complications of transsternal access. The article analyzes the preoperative factors for the development of complications, including concomitant pathology, constitutional features, bad habits, length of hospital stay, and urgency of the operation. It was also noted that intraoperative factors consist of technical errors in the operation, intraoperative features of the course of surgical intervention, the nature of the choice of shunt during myocardial vascularization and the completion of the operation. Postoperative risk factors include the management of the postoperative period in cardiac patients, that can lead to complications. The analysis of preventive measures taken by cardiac surgeons in the development of complications is presented.


2016 ◽  
Vol 23 (2) ◽  
pp. 99-109 ◽  
Author(s):  
Donata Ringaitienė ◽  
Dalia Gineitytė ◽  
Vaidas Vicka ◽  
Tadas Žvirblis ◽  
Jūratė Šipylaitė ◽  
...  

Background. Malnutrition (MN) is prevalent in cardiac surgery, but there are no specific preoperative risk factors of MN. The aim of this study is to assess the clinically relevant risk factors of MN for cardiac surgery patients. Materials and methods. The nutritional state of the patients was evaluated one day prior to surgery using a bioelectrical impedance analysis phase angle (PA). Two groups of patients were generated according to low PA: malnourished and well nourished. Risk factors of MN were divided into three clinically relevant groups: psychosocial and lifestyle factors, laboratory findings and disease-associated factors. Variables in each different group were entered into separate multivariate logistic regression models. Results. A total of 712 patients were included in the study. The majority of them were 65-year old men after a CABG procedure. Low PA was present in 22.9% (163) of patients. The analysis of disease-related factors of MN revealed the importance of heart functions (NYHA IV class OR: 3.073, CI95%: 1.416–6.668, p = 0.007), valve pathology (OR: 1.825, CI95%: 1.182–2.819, p = 0.007), renal insufficiency (OR: 4.091, CI95%: 1.995–8.389, p 


2012 ◽  
Vol 27 (2) ◽  
pp. 203-210 ◽  
Author(s):  
Marcos Gradim Tiveron ◽  
Alfredo Inácio Fiorelli ◽  
Eduardo Moeller Mota ◽  
Omar Asdrúbal Vilca Mejia ◽  
Carlos Manuel de Almeida Brandão ◽  
...  

2009 ◽  
Vol 30 (3) ◽  
pp. 242-248 ◽  
Author(s):  
Zeina A. Kanafani ◽  
Jean Marie Arduino ◽  
Lawrence H. Muhlbaier ◽  
Keith S. Kaye ◽  
Keith B. Allen ◽  
...  

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