Predictors of Low Cardiac Output Syndrome After Isolated Coronary Artery Bypass Grafting

Ding, Wenjun; Ji, Qiang; Shi, Yunqing; Ma, Ru

doi:10.1536/ihj.14-231

Cited by 64 publications

(64 citation statements)

References 20 publications

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“…These findings support those of study in 2014indicate that 3% of coronary artery bypass graft patients exhibit low cardiac output syndrome [45]. Low cardiac output affects a much higher percentage (13.5%) of patients undergoing coronary artery bypass graft surgery with old age, impaired left ventricular function, and emergence and incomplete revascularization being independent risk factors [46]. Length of stay: The study also established that the length of intensive care unit stay and days in the hospital after grafting is insignificant risk factors of surgical site infection in coronary artery bypass graft patients.…”

Section: Antibioticssupporting

confidence: 85%

Nursing Evaluation of Risk Factors Associated with Surgical Site Infection Among Coronary Artery Bypass Graft Patients at King Abdulaziz University Hospital

Johani¹

2017

AJNS

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Abstract:Surgical site infection is postoperative wound infection that occurs after surgery. The complications in the acute care facilities with up to 60% of surgical site infection cases estimated to be preventable by using evidence-based practice. Not with standing the advances in the coronary artery bypass graft, the rising prevalence of surgical site infection has become a primary concern in the infection control practices. The current study amid to evaluate the risk factors associated with the surgical site infections among coronary artery bypass graft patients and, to assess nurses compliance to bundle care to prevent surgical site infection. The study followed a quantitative, retrospective design and was carried out in King Abdulaziz University Hospital in Jeddah city. All sample (n= 120) coronary artery by-pass graft patient's record complied between January 2011 to December 2013.The study revealed statistically significant results between the preference of surgical site infection and demographic factor e.g. body mass index, patient risk factors such as diabetes type1 and 2, selected pre-operative factors e.g. Methicilin-resistant staphylococcus aurous, postoperative factors e.g. rewiring, dressing, ventilation and low cardiac output. This study established that the compliance with the bundle was proven to be effective in reducing risk factors to surgical site infection however nurses adherence to surgical site infection bundle care were incomplete and required more enforcement to comply. Based on the finding, the investigator recommended that nurses should be aware of the importance of adhering to surgical site infection bundles. Nurses should not only be educated on the importance of the bundles, but on how effectives apply the bundles at different stages.

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Section: Antibioticssupporting

confidence: 85%

Nursing Evaluation of Risk Factors Associated with Surgical Site Infection Among Coronary Artery Bypass Graft Patients at King Abdulaziz University Hospital

Johani¹

2017

AJNS

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“…Postoperative LCOS were considered with those who met the following criteria before discharge from first hospitalization in the intensive care unit immediately after surgery: 1. need for mechanical circulatory support with intra-aortic balloon pump to maintain systolic blood pressure greater than 90 mmHg after correction of electrolytes and blood gas abnormalities while adjusting preload volume to its optimal values; 2. signs of impairment of body perfusion after correction of electrolytes and blood gas abnormalities while adjusting preload volume to its optimal values. 14) Postoperative pulmonary complications included pneumonia (a positive result in a sputum culture requiring anti-infective treatment, or chest X-ray diagnosis of pneumonia following cardiac surgery) and respiratory failure, which was defined as the duration of mechanical ventilation more than 48 hours or re-intubation following surgery. 15) Postoperative stroke was defined as a new local or global cerebral dysfunction lasting over 24 hours.…”

Section: Methodsmentioning

confidence: 99%

Impact of Presurgical Mild Acute Respiratory Distress Syndrome on Surgical Mortality After Surgical Repair of Acute Type A Aortic Dissection

Lai²,

Sun

et al. 2017

Int. Heart J.

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SummaryTo evaluate the impact of presurgical mild acute respiratory distress syndrome (ARDS) on surgical mortality in patients undergoing surgical repair of acute type A aortic dissection by means of deep hypothermic circulatory arrest (DHCA) in a single-center, retrospective study.From January 2011 to December 2015, 333 eligible patients were divided into either a mild-ARDS group (n = 136) or a no-ARDS group (n = 197). The definition of mild ARDS referred to the recent revision of ARDS definition (Berlin criteria). The surgical mortality and major postoperative morbidity were investigated and analyzed.A total of 136 patients developed presurgical mild ARDS, with an incidence of 40.8%. No significant difference emerged between the 2 groups in major postoperative morbidity except for pulmonary complications. Multivariate logistic regression displayed that the risk of postoperative pulmonary complications in patients with presurgical mild ARDS was 4.25 times that in patients without presurgical ARDS (OR = 4.25, 95% CI 2.05-7.72). Twenty-four patients died after surgery, with significantly higher surgical mortality in the mild-ARDS group compared with the no-ARDS group (12.5% versus 3.6%, P = 0.002). Kaplan-Meier curves showed a poor surgical survival in the mild-ARDS group (χ 2 =12.958, Log-Rank P < 0.001). And Cox regression revealed the hazard ratio for surgical mortality in the mild-ARDS group compared with the no-ARDS group was 2.52 (95%CI 1.41-5.32, P = 0.016).Presurgical mild ARDS increased postoperative respiratory morbidity, and then increased surgical mortality after surgical repair of acute type A aortic dissection by means of DHCA (Int Heart J 2017; 58: 739-745) Key words: Mild acute respiratory distress syndrome, Acute type A aortic dissection, Deep hypothermic circulatory arrest, Surgical mortality, Morbidity A cute lung injury, which was used to describe mild acute respiratory distress syndrome (ARDS) previously, is one of most common presurgical complications following acute aortic dissection, with a prevalence of 30-45%. [1][2][3][4] Although it is recognized that activation of the inflammatory system caused by aortic injury due to acute aortic dissection may play a crucial role in the occurrence and development of acute lung injury, 1,5,6) the specific mechanism is still unclear. Acute lung injury or even severe ARDS is considered to be systemic complications of acute aortic dissection rather than a simple pulmonary disease. 7)An overwhelming majority of previous studies focused on evaluating risk factors for presurgical mild ARDS following acute aortic dissection, identifying the predictors for hypoxemia following surgical repair of acute type A aortic dissection by means of deep hypothermic circulatory arrest (DHCA), and exploring the pathogenesis of postoperative hypoxemia. However, few reports focused on evaluating the impacts of presurgical mild ARDS on surgical mortality and major postoperative morbidity in patients undergoing surgical repair of acute type A aortic dissection by means of DHC...

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“…We included patients with coronary disease requiring surgical treatment and LVEF less than or equal to 40%. Patients with absolute contraindication to the intra-aortic balloon, such as severe aortic insufficiency and aortic dissection, were excluded [6]- [8].…”

Section: Methodsmentioning

confidence: 99%

Preoperative Intra-Aortic Balloon Counterpulsation in Coronary Artery Bypass Graft Patients with Severe Left Ventricular Dysfunction

Freitas¹,

Gurian²,

Saporito³

et al. 2016

WJCD

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Background: The intra-aortic balloon pumping (IABP) is the most used ventricular mechanical assist device. In recent years, the preoperative use in patients with severe ventricular dysfunction presents itself as a great benefic strategy to the postoperative recovery. This paper aim is to evaluate the IABP post-operative benefit in patients with severe ventricular dysfunction. Methods: From January 2011 to March 2016, 125 patients underwent a coronary artery bypass graft (CABG) with cardiopulmonary bypass and preoperative IABP in Teaching Hospital of the ABC Medical School and Hospital Estadual Mario Covas. The inclusion criteria were the presence of severe ischemic cardiomyopathy with left ventricular ejection fraction (LVEF) less than or equal to 40%, estimated by Doppler echocardiography using the Simpson method. The preoperative LVEF was 30.25% ± 8.53% and the diastolic diameter of the left ventricle (LVDD) 67.75 ± 16.37 mm. IABP was installed approximately 15 hours before the surgery. Results: The patients required the IABP for 2.4 ± 1.58 days, and vasoactive drugs, 4.8 ± 2.12 days. We performed 3.2 ± 1.9 grafts per patient and the total length of stay was 07 ± 5.52 days. Cardiopulmonary bypass time was 67 ± 10.95 minutes and anoxia time, 46.4 ± 10.06 minutes. Twelve patients (9.6%) had pneumonia and four (3.2%), atrial fibrillation. We observed a LVDD reduction to 63 ± 16.26 (p = 0.068) and LVEF enhancement to 36.50 ± 16.86 (p = 0.144). The data were analyzed statistically according to the Wilcoxon test. There were no deaths. Conclusion: The initial experience of the authors with the preoperative IABP in patients with severe left ventricular dysfunction suggests great benefit in post-operative recovery with improvement of LVEF and reduction of LVDD.

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Predictors of Low Cardiac Output Syndrome After Isolated Coronary Artery Bypass Grafting

Cited by 64 publications

References 20 publications

Nursing Evaluation of Risk Factors Associated with Surgical Site Infection Among Coronary Artery Bypass Graft Patients at King Abdulaziz University Hospital

Nursing Evaluation of Risk Factors Associated with Surgical Site Infection Among Coronary Artery Bypass Graft Patients at King Abdulaziz University Hospital

Impact of Presurgical Mild Acute Respiratory Distress Syndrome on Surgical Mortality After Surgical Repair of Acute Type A Aortic Dissection

Preoperative Intra-Aortic Balloon Counterpulsation in Coronary Artery Bypass Graft Patients with Severe Left Ventricular Dysfunction

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