Open Heart Surgery: Management of Nonsurgical Bleeding in the Peri-Operative Period; 31/2-Years Institutional Experience
Journal Title: International Journal of Vascular Surgery and Medicine - Year 2017, Vol 3, Issue 1
Abstract
Background: Excessive perioperative bleeding remains a major complication following open heart surgery, resulting in increased morbidity and mortality of some patients in our institution. A study of the principal causes of excessive nonsurgical haemostatic perioperative bleeding, clinical evaluation, treatment and preventive strategies is justified. Objective/Aim: To characterize the causes of bleeding in patients with hemorrhage that did not require re-exploration and assess the impact on the patient outcomes from different causes of nonsurgical bleeding preoperatively. Materials and Methods: For a period of 31/2 years (March 2013 – February 2016), the National Cardiothoracic Center of Excellence, UNTH, Ituku/Ozalla, Enugu, Nigeria, partnered with different foreign cardiac missions (USA, UK and India) for the performance of open heart surgery. The case files of the patients managed in the envisaged period were retrieved and analyzed using SPSS, version 4.0. The data analyzed were patients’ demographics, the total number of open heart surgery cases, the number that had perioperative nonsurgical bleeding, clinical detection strategies, treatment and preventive modalities as well as the outcome. Results: During the period, a total number of 78 cases of open heart surgery (OHS) were done. There were 43 males and 35 females, with a ratio of approximately 4:3. The youngest age was 5 months and the oldest was 74 years, with a mean of 1.0. Out of these 78 cases, a total of 7 patients had perioperative nonsurgical bleeding, giving a percentage of 9%. 3 patients were noticed intraoperatively in the operating room (OR) while 4 were noticed postoperatively in the intensive care unit (ICU). Treatment included preoperative preventive strategies, the use of tranexemic acid or aprotinin, fresh frozen plasma (FFP) or fresh whole blood, platelet concentrate and additional doses of protamine, when incomplete reversal of heparin was the cause.
Authors and Affiliations
Nwafor IA, Eze JC, Ezemba N, Chinawa JM, Nzewi OC, Ngene CI
Keywords
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- EP ID EP347116
- DOI 10.17352/2455-5452.000019
- Views 54
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