Reexploration for Bleeding and Tamponade in Intensive Care Unit Following Open Heart Surgery

Ali  Özatik, Mehmet; Göl, Kamil; Budak, Baran; Küçüker, Şeref; Sarıtaş, Ahmet; Mavitaş, Binali; Şener, Erol; Taşdemir, Oğuz

Original Investigation

Mehmet Ali Özatik ¹ , Kamil Göl ² , Baran Budak ³ , Şeref Küçüker ⁴ , Ahmet Sarıtaş ⁵ , Binali Mavitaş ⁶ , Erol Şener ⁴ , Oğuz Taşdemir ¹

¹Türkiye Yüksek İhtisas Hastanesi Kalp Damar Cerrahisi Kliniği, Ankara, Türkiye
²Department of Cardiovascular Surgery Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
³Türkiye Yüksek ihtisas Hastanesi, Kardiyoloji Kliniği, Ankara, Türkiye
⁴Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, Ankara
⁵Türkiye Yüksek İhtisas Hastanesi Kalp ve Damar Cerrahisi Kliniği, Sıhhiye, Ankara, Türkiye
⁶Department of Cardiovascular Surgery, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey

Anatol J Cardiol 2004; 1(4): 19-22 PubMed ID: 15033612

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Abstract

Objective: Following open heart surgery some patients can need reexploration in the intensive care unit due to bleeding or pericardial tamponade. This study evaluates the impact of reexploration in the intensive care unit (ICU) on morbidity and mortality rates. Materials and Methods: Between January 1990 and January 2002 overall 18578 open heart surgery procedures were performed in our clinic and among them 570 (3%) patients required reexploration due to bleeding or pericardial tamponade. Reexplorations were done in the operating room (OR) in 385 (67.5%) patients and in the ICU in 185 (32.5%) patients. Results: Among patients 383(67.2%) were male and 187(32.8%) were female. Mean age for reexploration in the OR group was 46.9±16.3 years, and in the ICU group was 48.2±15.7 years. The use of fresh frozen plasma and bank blood was significantly higher in the ICU group (p<0.0001). Fifty patients (27%) who were reexplored in ICU had intraaortic balloon pump (IABP) support (p<0.0001). Sixty six patients (%17.1) died in OR group and 70 patients (37.8%) died in the ICU group (p<0.001). Following reexploration, 24 (6.2%) patients in the OR group and 17 (9.1%) patients in the ICU group had major infection (p>0.05). There was no statistically significant difference among groups in hospital stay time. Conclusion: Following open heart surgery, especially among hemodynamically unstable patients, to avoid possible problems of transfer to the OR and time lost, reexplorations can be done in ICU. This practice does not increase morbidity and hospital stay.

Keywords: Intensive care unit, bleeding, pericardial tamponade, reexploration

Açık Kalp Ameliyatları Sonrası Kanama veya Tamponad Nedeniyle Yoğun Bakımda Yapılan Reeksplorasyonlar

Mehmet Ali Özatik¹ , Kamil Göl² , Baran Budak³ , Şeref Küçüker⁴ , Ahmet Sarıtaş⁵ , Binali Mavitaş⁶ , Erol Şener⁴ , Oğuz Taşdemir¹

¹Türkiye Yüksek İhtisas Hastanesi Kalp Damar Cerrahisi Kliniği, Ankara, Türkiye
²Department of Cardiovascular Surgery Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
³Türkiye Yüksek ihtisas Hastanesi, Kardiyoloji Kliniği, Ankara, Türkiye
⁴Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, Ankara
⁵Türkiye Yüksek İhtisas Hastanesi Kalp ve Damar Cerrahisi Kliniği, Sıhhiye, Ankara, Türkiye
⁶Department of Cardiovascular Surgery, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey

The Anatolian Journal of Cardiology 2004; 1(4): 19-22 PMID: 15033612

Anahtar Kelimeler: Yoğun bakım, kanama, perikardiyal tamponad, re-eksplorasyon