Patients’ Perception of Stressful Events in the Intensive Care Unit After Cardiac Surgery

2019 ◽  
Vol 28 (2) ◽  
pp. 149-151 ◽  
Author(s):  
Mary G. Carey ◽  
Brandon W. Qualls ◽  
Colleen Burgoyne
Keyword(s):  
Intensive Care Unit ◽  
New York ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Stressful Events ◽  
University Hospital ◽  
Upstate New York ◽  
Stressful Experience

Background Subjecting patients to stress has potentially detrimental effects on their physical and psychological recovery. Objective To identify stress-generating experiences that occur in an intensive care unit for patients after cardiac surgery. Methods A sample of 16 patients in a 14-bed cardiovascular intensive care unit at a university hospital in upstate New York completed a questionnaire (based on an established survey) asking them to rate 23 experiences on a Likert scale of 0 to 4. All patients were adults and had undergone coronary artery bypass graft surgery. After surgery, they were extubated and completed the questionnaire within 12 to 24 hours. Results Patients reported pain to be the most stressful experience, followed by presence of an endotracheal tube and sleeplessness. Conclusions With pain, endotracheal intubation, and sleeplessness identified as highly distressing to patients, further research can be done to elicit interventions that could alleviate some of the stress involved with a postoperative stay in an intensive care unit.

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. 

scholarly journals Preoperative cardiac function parameters as valuable predictors for nurses to recognise delirium after cardiac surgery: A prospective cohort study

2019 ◽  
Vol 19 (4) ◽  
pp. 310-319 ◽  
Author(s):  
Shining Cai ◽  
Jos M Latour ◽  
Ying Lin ◽  
Wenyan Pan ◽  
Jili Zheng ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
New York ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Cardiac Function ◽  
Heart Association ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Functional Classification ◽  
New York Heart Association

Background: Delirium is a common postoperative complication after cardiac surgery. The relationship between delirium and cardiac function has not been fully elucidated. Aims: The aim of this study was to identify the association between preoperative cardiac function and delirium among patients after cardiac surgery. Methods: We prospectively recruited 635 cardiac surgery patients with a planned cardiac intensive care unit admission. Postoperative delirium was diagnosed using the confusion assessment method for the intensive care unit. Preoperative cardiac function was assessed using N-terminal prohormone of brain natriuretic peptide (NT-proBNP), New York Heart Association functional classification and left ventricular ejection fraction. Results: Delirium developed in 73 patients (11.5%) during intensive care unit stay. NT-proBNP level (odds ratio (OR) 1.24, 95% confidence interval (CI) 1.01–1.52) and New York Heart Association functional classification (OR 2.34, 95% CI 1.27–4.31) were both independently associated with the occurrence of delirium after adjusting for various confounders. The OR of delirium increased with increasing NT-proBNP levels after the turning point of 7.8 (log-transformed pg/ml). The adjusted regression coefficients were 1.19 (95% CI 0.95–1.49, P=0.134) for NT-proBNP less than 7.8 (log-transformed pg/ml) and 2.78 (95% CI 1.09–7.12, P=0.033) for NT-proBNP greater than 7.8 (log-transformed pg/ml). No association was found between left ventricular ejection fraction and postoperative delirium. Conclusion: Preoperative cardiac function parameters including NT-proBNP and New York Heart Association functional classification can predict the incidence of delirium following cardiac surgery. We suggest incorporating an early determination of preoperative cardiac function as a readily available risk assessment for delirium prior to cardiac surgery.

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.

scholarly journals Risk factors for mediastinitis in the post-operative period of heart surgery

2020 ◽  
pp. 971-976
Author(s):  
Debora Ferreira da Cruz ◽  
Elbanir Rosangela Ferreira de Sousa ◽  
Claudia Elizabeth de Almeida
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Rio De Janeiro ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
University Hospital ◽  
Postoperative Risk ◽  
Study Population ◽  
The Relationship

Objectives: The study’s main purpose has been to identify both pre and postoperative risk factors related to the development of mediastinitis among patients who underwent cardiac surgery at a hospital from the Rio de Janeiro city. Furthermore, to characterize the study population and to analyze the relationship between risk factors and the incidence of mediastinitis in patients who underwent cardiac surgery. Methods: It is a descriptive and retrospective study with a quantitative approach, where there were identified the risk factors related to the development of mediastinitis in patients who underwent cardiac surgery at a university hospital from the Rio de Janeiro State. Results: There were obtained a total of 192 patients, mostly males, within the age group from 50 to 69 years old and overweight. Diabetes mellitus and smoking were the most frequent comorbidities, and coronary artery bypass graft surgery was the most performed surgery, 4 patients had mediastinitis. Conclusion: The identification of such factors contributes to the elaboration of prevention strategies for mediastinitis, and the implementation of nursing care in both pre and postoperative periods of cardiac surgeries.

Increase in the Rate of Sternal Surgical Site Infection After Coronary Artery Bypass Graft: A Marker of Higher Severity of Illness

2007 ◽  
Vol 28 (6) ◽  
pp. 655-660 ◽  
Author(s):  
Mohamad G. Fakih ◽  
Mamta Sharma ◽  
Riad Khatib ◽  
Dorine Berriel-Cass ◽  
Susan Meisner ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Artery Bypass ◽  
Risk Index ◽  
Bypass Graft ◽  
Severity Of Illness ◽  
Site Infection ◽  
Artery Bypass Graft ◽  
Peripheral Vascular ◽  
Duration Of Surgery

Objective.To evaluate factors related to a gradual rise in sternal surgical site infection (SSI) rates.Design.Retrospective cohort study.Setting.A 608-bed, tertiary care teaching hospital.Patients.All patients who underwent coronary artery bypass graft (CABG) from January 2000 through September 2004.Results.Of 3,578 patients who underwent CABG, 144 (4%) had sternal SSI. There was an increase in infection rate, with a marked reduction in the number of operations per year. The percentage of patients with peripheral vascular disease increased from 12% to 24.3% (P < .001), and the percentage with congestive heart failure increased from 17% to 22% (P < .001). Between 2002 and 2004, the mean duration of surgery increased from 233 to 290 minutes (P < .001), the percentage of patients with a National Nosocomial Infections Surveillance System (NNIS) risk index of 2 increased from 14.3% to 38% (P < .001), and the percentage of patients with a postoperative stay in the intensive care unit of greater than 72 hours increased from 29% to 40.6% (P < .001). Multivariate analysis showed diabetes mellitus, peripheral vascular disease, obesity, duration of surgery, and postoperative stay in the intensive care unit of greater than 72 hours to be independently associated with infection.Conclusions.An increase in infection in the CABG population not associated with an outbreak may be a reflection of a change in the severity of illness. Preoperative, intraoperative, and postoperative markers for increased infection risk may be used, in addition to the NNIS risk index, to assess the patient population risk.

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