Delayed Sternal Closure in Cardiac Surgery

Schultheis, Siavash Saadat Molly

doi:10.4172/2155-9880.1000375

J Clin Exp Cardiolog

2015

DOI: 10.4172/2155-9880.1000375

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Delayed Sternal Closure in Cardiac Surgery

Siavash Saadat Molly Schultheis¹

Abstract: Background: Delayed sternal closure (DSC) has a reported incidence of 1.2%-4.2% in the adult cardiac surgical literature for indications including hemodynamic instability, marked myocardial edema, respiratory compromise, intractable bleeding, placement of assist devices, and persistent arrhythmias. The purpose of this study was to evaluate the incidence, survival, and morbidity of open chest management (OCM) patients who subsequently required DSC.

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2024

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Cited by 1 publication

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Early clinical outcomes of two regimens of prophylactic antibiotics in cardiac surgical patients with delayed sternal closure

Eissa,

Kaddoura,

Hassan

et al. 2024

World J Crit Care Med

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BACKGROUND Delayed sternal closure (DSC) can be a lifesaving approach for certain patients who have undergone cardiac surgery. The value of the type of prophylactic antibiotics in DSC is still debatable. AIM To investigate clinical outcomes of different prophylactic antibiotic regimens in patients who had DSC after cardiac surgery. METHODS This was a retrospective observational single-center study. Fifty-three consecutive patients who underwent cardiac surgery and had an indication for DSC were included. Patients were subjected to two regimens of antibiotics: Narrow-spectrum and broad-spectrum regimens. RESULTS The main outcome measures were length of hospital and intensive care unit (ICU) stay, duration of mechanical ventilation, and mortality. Of the 53 patients, 12 (22.6%) received narrow-spectrum antibiotics, and 41 (77.4%) received broad-spectrum antibiotics. The mean age was 59.0 ± 12.1 years, without significant differences between the groups. The mean duration of antibiotic use was significantly longer in the broad-spectrum than the narrow-spectrum group (11.9 ± 8.7 vs 3.4 ± 2.0 d , P < 0.001). The median duration of open chest was 3.0 (2.0-5.0) d for all patients, with no difference between groups (P = 0.146). The median duration of mechanical ventilation was significantly longer in the broad-spectrum group [60.0 (Δ interquartile range (IQR) 170.0) h vs 50.0 (ΔIQR 113.0) h, P = 0.047]. Similarly, the median length of stay for both ICU and hospital were significantly longer in the broad-spectrum group [7.5 (ΔIQR 10.0) d vs 5.0 (ΔIQR 5.0) d, P = 0.008] and [27.0 (ΔIQR 30.0) d vs 19.0 (ΔIQR 21.0) d, P = 0.031]. Five (9.8%) patients were readmitted to the ICU and 18 (34.6%) patients died without a difference between groups. CONCLUSION Prophylactic broad-spectrum antibiotics did not improve clinical outcomes in patients with DSC post-cardiac surgery but was associated with longer ventilation duration, length of ICU and hospital stays vs narrow-spectrum antibiotics.

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Early clinical outcomes of two regimens of prophylactic antibiotics in cardiac surgical patients with delayed sternal closure

Eissa,

Kaddoura,

Hassan

et al. 2024

World J Crit Care Med

View full text Add to dashboard Cite

show abstract

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Delayed Sternal Closure in Cardiac Surgery

Cited by 1 publication

References 14 publications

Early clinical outcomes of two regimens of prophylactic antibiotics in cardiac surgical patients with delayed sternal closure

Early clinical outcomes of two regimens of prophylactic antibiotics in cardiac surgical patients with delayed sternal closure

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