Judy Currey1, Mari Botti. 1. Alfred/Deakin Nursing Research Centre, Deakin University, 221 Burwood Highway, Burwood Victoria 3125, Australia. curreyj@deakin.edu.au
Abstract
BACKGROUND: Critical care nurses caring for cardiac patients in the immediate postoperative period continually make decisions about the implications and treatment of their patients' haemodynamic status. AIM: The aim of this study was to describe the haemodynamic status of patients on admission to critical care and over the 2-h period following cardiac surgery. METHODS: A quantitative, descriptive design was used. Data were collected using non-participant observation and an observation tool. The sample consisted of 38 patients. RESULTS: Analysis of data revealed the dynamic nature of the haemodynamic status of postoperative cardiac patients. On admission, 60% of patients (n=23) were haemodynamically unstable. The instability in these patients (n=23) was due to hypotension (34%), bleeding (21%) and hypoxaemia (18%). During the 2-h recovery period, 55% of patients were hypotensive, 16% of patients had low cardiac output syndrome and 16% of patients had low systemic vascular resistance (SVR) syndrome. Twenty-one percent of patients experienced bleeding complications. Shivering was a clinically significant problem in terms of occurrence (23%) and duration (X=45, S.D.=30 min). Twenty-nine percent of patients (n=11) had a profound deterioration in haemodynamic status, necessitating urgent interventions. CONCLUSION: Haemodynamic parameters indicate that 95% of patients in this study were haemodynamically unstable at some time during the initial 2-h recovery period. These findings inform resourcing decisions by organisations and have implications for nurses' assessment and interventional haemodynamic decision making.
BACKGROUND: Critical care nurses caring for cardiac patients in the immediate postoperative period continually make decisions about the implications and treatment of their patients' haemodynamic status. AIM: The aim of this study was to describe the haemodynamic status of patients on admission to critical care and over the 2-h period following cardiac surgery. METHODS: A quantitative, descriptive design was used. Data were collected using non-participant observation and an observation tool. The sample consisted of 38 patients. RESULTS: Analysis of data revealed the dynamic nature of the haemodynamic status of postoperative cardiac patients. On admission, 60% of patients (n=23) were haemodynamically unstable. The instability in these patients (n=23) was due to hypotension (34%), bleeding (21%) and hypoxaemia (18%). During the 2-h recovery period, 55% of patients were hypotensive, 16% of patients had low cardiac output syndrome and 16% of patients had low systemic vascular resistance (SVR) syndrome. Twenty-one percent of patients experienced bleeding complications. Shivering was a clinically significant problem in terms of occurrence (23%) and duration (X=45, S.D.=30 min). Twenty-nine percent of patients (n=11) had a profound deterioration in haemodynamic status, necessitating urgent interventions. CONCLUSION: Haemodynamic parameters indicate that 95% of patients in this study were haemodynamically unstable at some time during the initial 2-h recovery period. These findings inform resourcing decisions by organisations and have implications for nurses' assessment and interventional haemodynamic decision making.
Authors: Katarzyna Gendera; Grzegorz Lipecki; Marcin Miedziński; Bartłomiej Prędki; Wojciech Mrówczyński Journal: Kardiochir Torakochirurgia Pol Date: 2016-03-30