The haemodynamic status of cardiac surgical patients in the initial 2-h recovery period

Eur J Cardiovasc Nurs. 2005 Sep;4(3):207-14. doi: 10.1016/j.ejcnurse.2005.03.007.

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.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Cardiac Output, Low / diagnosis
  • Cardiac Output, Low / nursing
  • Cardiac Surgical Procedures / adverse effects
  • Cardiac Surgical Procedures / methods*
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / nursing
  • Cardiovascular Diseases / surgery
  • Critical Care / methods
  • Female
  • Follow-Up Studies
  • Hemodynamics / physiology*
  • Humans
  • Male
  • Middle Aged
  • Monitoring, Physiologic / nursing*
  • Nursing Assessment
  • Postoperative Complications / diagnosis
  • Postoperative Complications / nursing*
  • Postoperative Period
  • Recovery Room
  • Risk Assessment
  • Time Factors
  • Treatment Outcome