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Source:

Nursing2015

March 2003, Volume 33 Number 3 , p 32cc1 - 32cc4

Authors

  • KIM HENKE RN, MPA, MSN
  • JANICE EIGSTI RN, CCRN, BSN

Abstract

Outline

  • Abstract

  • Cardioplegia: Cold-hearted surgery

  • Five types of problems

  • Your knowledge goes a long way

  • SELECTED REFERENCES

  • Abstract

    Few patients run into severe postoperative problems, but yours may be the exception. Here's how to respond.

    Despite significant advances made in cardiac surgery over the last 2 decades, cardiopulmonary bypass (CPB) still sometimes triggers physiologic complications that hamper a patient's recovery from open-heart surgery. In this article, we'll describe some of these potential injuries and ways you can help your patient.

    Cardioplegia: Cold-hearted surgery

    Ideally, cardiothoracic surgery is done on a motionless and “bloodless” heart. Because a normal core body temperature tends to trigger electrical activity in the heart and increase the heart's metabolic rate, the surgeon may also infuse a cold solution through the coronary artery circulation via catheters placed in the aortic root or the coronary sinus. This effectively paralyzes the heart (cardioplegia), keeping it motionless and cool. This cardioprotective technique works hand in hand with CPB to keep the heart in a state of temporary arrest.

    Most patients don't experience severe complications following cardioplegia and CPB, but having a clear understanding of potential adverse effects will help you provide the best care for your patients.

    Five types of problems

    Complications of CPB fall into five major areas: cardiovascular, hematologic, renal, pulmonary, and neurologic. Let's look closely at each type.

    Cardiovascular complications . A patient's surgical outcome depends heavily on how well the heart is protected during surgery. Cardioplegia, in large part, provides this protection through cooling, and the choice of solution used can further protect the heart.

    The ...

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