Açık Kalp Cerrahisi Sonrası Klinik Bakım

Özet

Açık kalp cerrahisi, kalp kapakçıkları ya da kalbin ana damarları ile ilgili cerrahi işlem gerektiren hastalıkların tedavisinde kullanılan bir tedavi yöntemdir. Hastaların yaşam kalitesi ve yaşam süreleri üzerine olumlu etki yapmaktadır. Açık kalp cerrahisi sonrası hızlı iyileşmenin sağlanması ve olası komplikasyonların önlenmesi, verilen klinik bakımın kalitesi ile doğru orantılı olarak değişmektedir. Klinik bakımın temel amacı anestezi ve cerrahi işleme bağlı bozulan homeostatik dengenin hızlı bir şekilde yeniden düzenlenmesini sağlamaktır. Bu süreçte hemşireler kilit rol oynamaktadır.

 

Open heart surgery is a method used to treat diseases that require surgical procedures on the heart, heart valves, or main vessels of the heart. Open heart surgery positively impacts patients' quality of life and life expectancy. Ensuring rapid recovery and preventing possible complications after open heart surgery varies directly to the quality of clinical care provided. The main aim of clinical care is to ensure rapid restoration of the homeostatic balance disturbed by anesthesia and surgical procedures. Nurses play a key role in this process.

Referanslar

Esmealy L, Allahbakhshian A, Gholizadeh L, et al. Effects of early mobilization on pulmonary parameters and complications post coronary artery bypass graft surgery. App Nurs Res; 2023; 69;151653. doi:10.1016/j.apnr.2022.151653

Cüre D. Koroner arter bypass greftleme sonrası yoğun bakımda uygulanabilecek güvenli alt ekstremite egzersiz modelleri: Bisiklet Ergometresi ve tüm vücut titreşimi. Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi; 2021;5(2):371-379. doi: 10.46237/amusbfd.796401

Engelman DT, Ben AW, Williams JB, et al. Guidelines for perioperative care in cardiac surgery: enhanced recovery after surgery society recommendations. JAMA Surgery; 2019;154(8):755–766. doi: 10.1001/jamasurg.2019.1153

Mertes PM, Kindo M, Amour J, et al. Guidelines on enhanced recovery after cardiac surgery under cardiopulmonary bypass or off-pump. Anaesthesia Critical Care & Pain Medicine; 2022;41(3):101059. doi: 10.1016/j.accpm.2022.101059

Borys M, Żurek S, Kurowicki A, et al. Implementation of Enhanced Recovery After Surgery (ERAS) protocol in off-pump coronary artery bypass graft surgery. A prospective cohort feasibility study. Anaesthesiol Intensive Ther; 2020;52(1):10-14. doi: 10.5114/ait.2020.93160

Ball L, Costantino F, Pelosi P. Postoperative complications of patients undergoing cardiac surgery. Curr Opin Crit Care; 2016;22(4):386–392. doi: 10.1097/MCC.0000000000000319

Tanner TG, Colvin MO. Pulmonary Complications of Cardiac Surgery. Lung; 2020; 198(6):889-896. doi: 10.1007/s00408-020-00405-7

DiMarco RF. Postoperative Care of the Cardiac Surgical Patient. Surgical Intensive Care Medicine; 2010; 535-566. 10.1007/978-0-387-77893-8_47

Santos PMR, Ricci NA, Suster ÉA, et al. Effects of early mobilisation in patients after cardiac surgery: a systematic review. Physiotherapy; 2017;103(1):1-12. doi: 10.1016/j.physio.2016.08.003

Aygin D, Kalkan ÖK, Akbayır N. Ameliyat sonrası erken dönem mobilizasyonun hızlı iyileşmeye katkısı. Sakarya Üniversitesi Holistik Sağlık Dergisi; 2022;5(3):392-403. doi: 10.54803/sauhsd.1168814

Stephens RS, Whitman GJR. Postoperative critical care of the adult cardiac surgical patient. Part I: Routine postoperative care. Crit Care Med; 2015;43(7):1477–97. doi: 10.1097/CCM.0000000000001059

Morris PE, Goad A, Thompson C, Taylor K, Harry B, Passmore L, et al. Early intensive care unit mobility therapy in the treatment of acute respiratory failure. Crit Care Med; 2008;36(8):2238–2243. doi:10.1097/CCM.0b013e318180b90e

Schmidt UH, Knecht L,MacIntyre NR. Should early mobilization be routine in mechanically ventilated patients? Respir Care; 2016;61(6):867-875. doi: 10.4187/respcare.04566.

Çelik S. Kardiyak cerrahi girişim sonrası solunum komplikasyonları. Yoğun Bakım Hemşireliği Dergisi; 2007;11(2):67–73. (20.08.2023 tarihinde https://dergipark.org.tr/en/download/article-file/260092 adresinden ulaşılmıştır).

Ohbe H, Nakamura K, Uda K, et al. Effect of early rehabilitation on physical function in patients undergoing coronary artery bypass grafting: A nationwide inpatient database study. J Clin Med; 2021;10(4):618. doi: 10.3390/jcm10040618

Mavili I, Şahutoğlu C, Pestilci Z, et al. Koroner arter baypas greftleme cerrahisi sonrası erken dönemde gelişen komplikasyonlar ve ilişkili etiyolojik faktörler. Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi; 2016;22(1):16-23. doi:10.5222/GKDAD.2016.016

Tariq MI, Khan AA, Khalid Z, et al. Effect of early≤ 3 mets (metabolic equivalent of tasks) of physical activity on patient's outcome after cardiac surgery. J Coll Physicians Surg Pak; 2017;27(8):490-4. (16.09.2023 Tarihinde https://www.researchgate.net/profile/Iqbal-Tariq/publication/320243259_Effect_of_Early_3_Mets_Metabolic_Equivalent_of_Tasks_of_Physical_Activity_on_Patient's_Outcome_after_Cardiac_Surgery/links/59d708290f7e9b42a6ab3fe3/Effect-of-Early-3-Mets-Metabolic-Equivalent-of-Tasks-of-Physical-Activity-on-Patients-Outcome-after-Cardiac-Surgery.pdf adresinden ulaşılmıştır).

Sarkar M, Prabhu V. Basics of cardiopulmonary bypass. Indian J Anaesth; 2017;61(9): 760. doi: 10.4103/ija.IJA_379_17

Mali S, Haghaninejad H. Pulmonary complications following cardiac surgery. Arch Med Sci Atheroscler Dis; 2019; 4(1):280-285. doi: 10.5114/amsad.2019.91432

Moradian ST, Najafloo M, Mahmoudi H, et al. Early mobilization reduces the atelectasis and pleural effusion in patients undergoing coronary artery bypass graft surgery: a randomized clinical trial. J Vasc Nurs; 2017;35(3):141-145. doi: 10.1016/j.jvn.2017.02.001

Kanejima Y, Shimogai T, Kitamura M, et al. Effect of early mobilization on physical function in patients after cardiac surgery: a systematic review and meta-analysis. Int J Environ Res Public Health; 2020;17(19):7091. doi: 10.3390/ijerph17197091

Miranda Rocha AR, Martinez BP, Maldaner da Silva VZ, et al. Early mobilization: Why, what for and how? Med Intensiva (English Edition); 2017;41(7):429–436. doi:10.1016/j.medine.2016.10.011

Borges DL, Silva MG, Silva LN, et al. Effects of aerobic exercise applied early after coronary artery bypass grafting on pulmonary function, respiratory muscle strength, and functional capacity: a randomized controlled trial. J Phys Act Health; 2016;13(9):946-951. doi: 10.1123/jpah.2015-0614

Kho ME, Martin RA, Toonstra AL, et al. Feasibility and safety of in-bed cycling for physical rehabilitation in the intensive care unit. J Crit Care; 2015;30(6):1419-e1. doi: 10.1016/j.jcrc.2015.07.025.

Wollersheim T, Haas K, Wolf S, et al. Whole-body vibration to prevent intensive care unit-acquired weakness: safety, feasibility, and metabolic response. Crit Care; 2017;21(1):1-10. doi: 10.1186/s13054-016-1576-y

Bein T, Bischoff M, Brückner U, et al. S2e guideline: positioning and early mobilisation in prophylaxis or therapy of pulmonary disorders: revision 2015: S2e guideline of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI). Anaesthesist; 2015;64(1):1-26. doi: 10.1007/s00101-015-0071-1

Westerdahl E, Möller M. Physiotherapy—supervised mobilization and exercise following cardiac surgery: a national questionnaire survey in Sweden. J Cardiothorac Surg; 2010;5(67):1-7. doi: 10.1186/1749-8090-5-67

Uğurlu AK, Kula Şahin S, Seçginli S, et al. Ameliyat sonrası ilk 24 saatte erken ayağa kaldırmanın hızlı iyileşmeye etkisi: Sistematik derleme. Turkiye Klinikleri Journal of Nursing Sciences. 2017;9(4):280- 288. doi: 10.5336/nurses.2016-53678

McConnell G, Woltz P, Bradford WT, et al. Enhanced recovery after cardiac surgery program to improve patient outcomes. Nursing; 2018;48(11):24-31. doi: 10.1097/01.NURSE.0000546453.18005.3f

Henderson, V. The nature of nursing. Am J Nurs; 1964; 64(8):62–68. doi:10.2307/3419278

Orem DE. Self-care deficit theory of nursing. Nursing theorists and their work 1989. (04/09/2023 tarihinde https://nurseslabs.com/dorothea-orems-self-care-theory/ adresinden ulaşılmıştır).

Silva KA, Medeiros SM, Paulino TSC, et al. Nurses’ Role in Post-Operative Immediately Myocardial Revascularization in Intensive Care Unit. International Archives of Medicine; 2016;9(199):1-7. doi: 10.3823/2070

Balachandran S, Lee A, Royse A, et al. Upper limb exercise prescription following cardiac surgery via median sternotomy: a web survey. J Cardiopulm Rehabil Prev; 2014;34(6):390-395. doi: 10.1097/HCR.0000000000000053

Bailey P, Thomsen GE, Spuhler VJ, et al. Early activity is feasible and safe in respiratory failure patients. Crit Care Med; 2007;35(1):139-145. doi: 10.1097/01.CCM.0000251130.69568.87

Olkowski BF, Shah SO. Early mobilization in the Neuro-ICU: How Far Can We Go? Neurocrit Care; 2017;27(1):141-150. doi: 10.1007/s12028-016-0338-7

Hodgson CL, Stiller K, Needham DM, et al. Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults. Crit Care; 2014;18(6):1-9. doi: 10.1186/s13054-014-0658-y

TEAM-Study-Investigators. Early mobilization and recovery in mechanically ventilated patients in the ICU: a bi-national, multi-centre, prospective cohort study. Crit Care; 2015;19(1):81-91. doi: 10.1186/s13054-015-0765-4

Katijjahbe MA, Granger CL, Denehy L, et al. Standard restrictive sternal precautions and modified sternal precautions had similar effects in people after cardiac surgery via median sternotomy (‘SMART’Trial): a randomised trial. J Physiother; 2108;64(2):97-106. doi: 10.1016/j.jphys.2018.02.013

Ludwig C, Angenendt S, Martins R, et al. Intermittent positive-pressure breathing after lung surgery. Asian Cardiovasc Thorac Ann; 2011;19(1):10-13. doi: 10.1177/0218492310394664

Martin CG, Turkelson SL. Nursing care of the patient undergoing coronary artery bypass grafting. J Cardiovasc Nurs; 2006;21(2):109–17, doi: 10.1097/00005082-200603000-00006

Yıldızeli Topçu S. Hastalarin solunum egzersizi uygulamalarini etkileyen faktörler ve hemşirelerin rolü. İzmir Göğüs Hastanesi Dergisi; 2016;30(2):89-96. (10.09.2023 tarihinde https://dergipark.org.tr/en/download/article-file/643017 adresinden ulaşılmıştır

Kendall F, Oliveira J, Peleteiro B, et al. Inspiratory muscle training is effective to reduce postoperative pulmonary complications and length of hospital stay: a systematic review and meta-analysis. Disabil Rehabil; 2018;40(8):864- 882. doi:10.1080/09638288.2016.1277396

Allam ZA, Mohamed SS, Mahmoud OFT, et al. Efekt of active cycle breathing technique on airway clearance among patients underwent cardiac surgery. Tanta Scientific Nursing Journal; 2023;29(2), 172-188. doi: 10.21608/tsnj.2023.306369

Kankaya, E. A., & Bilik, Ö. Kalp kapak ameliyatı sonrası güncel hemşirelik yaklaşımları: Bakım neden önemli? Balıkesir Sağlık Bilimleri Dergisi; 2019;7(2):101-111. doi: 10.5505/bsbd.2018.93585

McTier L, Botti M, Duke M. Patient participation in pulmonary interventions to reduce postoperative pulmonary complications following cardiac surgery. Aust Crit Care; 2016;29(1):35–40. doi: 10.1016/j.aucc.2015.04.001

Shalli S, Saeed D, Fukamachi K, et al. Chest tube selection in cardiac and thoracic surgery: A survey of chest tube‐related complications and their management. J Card Surg; 2009;24(5):503-509. doi: 10.1111/j.1540-8191.2009.00905.x

Ukeh I, Fang A, Patel S, et al. Percutaneous chest tube for pleural effusion and pneumothorax. Semin Intervent Radiol; 2022;31;39(3):234-247. doi: 10.1055/s-0042-1751295

Obafemi OO, Wang H, Bajaj SS, et al. An automated line-clearing chest tube system after cardiac surgery. JTCVS Open; 2022;24(10):246-253. doi:10.1016/j.xjon.2022.02.020.

Christensen MC, Dziewior F, Kempel A, et al. Increased chest tube drainage is independently associated with adverse outcome after cardiac surgery. J Cardiothorac Vasc Anesth; 2012;26(1):46-51. doi:10.1053/j.jvca.2011.09.021

Balzer F, von Heymann C, Boyle EM, et al. Impact of retained blood requiring reintervention on outcomes after cardiac surgery. J Thorac Cardiovasc Surg; 2016;152(2):595-601.e4. doi: 10.1016/j.jtcvs.2016.03.086

Gregory AJ, Grant MC, Manning MW, et al. Enhanced recovery after cardiac surgery (ERAS Cardiac) recommendations: an important first step-but there is much work to be done. J Cardiothorac Vasc Anesth; 2020;34(1):39-47. doi: 10.1053/j.jvca.2019.09.002

Boyle Jr EM , Gillinov AM, Cohn WE, et al. Retained blood syndrome after cardiac surgery: A new look at an old problem. Innovations (Phila); 2015;10(5):296-303. doi: 10.1097/imi.0000000000000200

St-Onge S, Perrault LP, Demers P, et al. Pericardial blood as a trigger for postoperative atrial fibrillation after cardiac surgery. Ann Thorac Surg; 2018;105(1):321-328. doi:10.1016/j.athoracsur.2017. 07.045

Anderson D, Chen SA, Godoy LA, et al. Comprehensive review of chest tube management: a review. JAMA Surgery; 2022;157(3):269-274. doi: 10.1001/jamasurg.2021.7050.

Horsley A, Jones L, White J, et al. Efficacy and complications of small-bore, wire-guided chest drains. Chest; 2006; 130(6):1857-1863. doi: 10.1378/chest.130.6.1857

Davies HE, Merchant S, McGown A. A study of the complications of small bore 'Seldinger' intercostal chest drains. Respirology; 2008;13(4):603-607. doi: 10.1111/j.1440-1843.2008.01296.x

Chestovich PJ, Jennings CS, Fraser DR, et al. Too big, too small or just right? Why the 28 French chest tube is the best size. J Surg Res; 2020;256:338-344. doi: 10.1016/j.jss.2020.06.048

Gan KL, Tan M. Evidence-based management of patients with chest tube drainage system to reduce complications in cardiothoracic vascular surgery wards. Int J Evid Based Healthc; 2015; 13(2):58–65. doi: 10.1097/XEB.0000000000000041

Di Ciacca L, Neal M, Highcock M, et al. Guidelines for the Insertion and Management of Chest Drains. Royal United Hospital Bath. NHS. 2012:1–13. (11.09.2023 Tarinde https://www.yumpu.com/en/document/view/5804300/guidelines-for-the-insertion-and-management-of-chest-medekit adresinden ulaşılmıştır).

Erdil F, Özhan Elbaş N. Cerrahi Hastalıkları Hemşireliği. In: Erdil F, Özhan Elbaş (eds.) Göğüs Tüplü Hasta Bakımı, Ankara; Aydoğdu Ofset: 2012. p. 287-297.

Halm MA. To strip or not to strip? physiological effects of chest tube manipulation. Am J Crit Care; 2007;16(6):609-612. (12.09.2023 Tarihinde https://clearflow.com/wp-content/uploads/2021/07/Halm.To-Strip-or-Not-to-Strip.-Physiological-Effects-of-Chest-Tube-Manipulations.2007.pdf adresinden ulaşılmıştır)

Day TG, Perring RR, Gofton K. Is manipulation of mediastinal chest drains useful or harmful after cardiac surgery? Interact Cardiovasc Thorac Surg; 2008;7(5):888-90. doi: 10.1510/icvts.2008.185413

Grieshaber P, Heim N, Herzberg M, et al.. Active chest tube clearance after cardiac surgery is associated with reduced reexploration rates. The Ann Thorac Surg; 2018;105(6), 1771-77. doi: 10.1016/j.athoracsur.2018.01.002

Kwiatt M, Tarbox A, Seamon MJ, et al. Thoracostomy tubes: a comprehensive review of complications and related topics. Int J Crit Illn Inj Sci; 2014;4(2):143-55. doi: 10.4103/2229-5151.134182

Mirmohammad-Sadeghi M, Etesampour A, Gharipour M, et al. Early chest tube removal after coronary artery bypass graft surgery. N Am J Med Sci; 2009;1(7):333–337. doi: 10.4297/najms.2009.7333

Lobdell KW, Engelman DT. Chest tube management: past, present, and future directions for developing evidence-based best practices. Innovations (Phila); 2023;18(1):41-48. doi: 10.1177/15569845231153623

George B. An Integrative review of fluid management in cardiac surgery. Master's Theses; 2018 (04/09/2023 tarihinde https://core.ac.uk/download/pdf/232661737.pdf adresinden ulaşılmıştır).

Young R. Perioperative fluid and electrolyte management in cardiac surgery: A Review J Extra Corpor Technol; 2012; 44(1):20-26. (10.09.2023 Tarihinde https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4557443/pdf/ject-44-P20.pdf adresinden ulaşılmıştır).

Polderman KH, Girbes AR. Severe electrolyte disorders following cardiac surgery: a prospective controlled observational study. Crit Care; 2004;8(6):459-466. doi: 10.1186/cc2973

Hosseini S, Salari S, Banar S, et al. Hypothermia-induced accelerated idioventricular rhythm after cardiac surgery; a case report. BMC Cardiovasc Disord; 2023; 23(142):1-6.. doi.org/10.1186/s12872-023-03178-y

Shaw A, Raghunathan K. Fluid management in cardiac surgery: colloid or crystalloid? Anesthesiol Clin; 2013;31(2):269-280. doi: 10.1016/j.anclin.2012.12.007

Lannemyr L, Bragadottir G, Hjärpe A, et al. Impact of cardiopulmonary bypass flow on renal oxygenation in patients undergoing cardiac operations. Ann Thorac Surg; 2019;107(2):505-11. doi: 10.1016/j.athoracsur.2018.08.085

Toraman, F. Kalp cerrahisinde sıvı elektrolit tedavisi. Göğüs-Kalp-Damar Anestezi ve Yoğun Bakım Derneği Dergisi; 2013; 19(2): 53-66. doi: 10.5222/GKDAD.2013.053

Ardò NP, Loizzi D, Panariti S, Piccinin I, Sollitto F. Enhanced recovery pathways in thoracic surgery from Italian VATS group: nursing care program. J Thorac Dis; 2018;10(4):S529-S534. doi: 10.21037/jtd.2017.12.85

Osawa EA, Rhodes A, Landoni G, et al. Effect of perioperative goal-directed hemodynamic resuscitation therapy on outcomes following cardiac surgery: a randomized clinical trial and systematic review. Crit Care Med; 2016;44(4): 724-733. doi: 10.1097/CCM.0000000000001479

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