Articles: postoperative-complications.
-
One hundred heart surgery patients were followed throughout their postoperative periods to assess the incidence and etiology of postcardiotomy delirium. Factors evaluated were: age, sex, history of previous psychiatric illness, history of cerebrovascular disease, cardiac diagnosis and operation, time of anesthesia, time of bypass, time spent in the intensive-care unit, and amount of sleep during the postoperative period. Six patients developed delirium, five of whom had a lucid postoperative interval; four patients had perceptual disturbances only, without loss of contact with reality; three had neurological symptoms with mild confusion; 87 kept a clear mental state. ⋯ Operative factors did not seem to be of major importance. While postoperative delirium probably has multidetermined causes, the author believes that sleep deprivation superimposed on the other contributory condition is a common precipitating factor. Suggestions about the prevention and treatment of delirium are made.
-
Respiratory care of patients undergoing open heart surgery should begin in the preoperative period. Patients must stop smoking, and if obese they are encouraged to lose weight. Pulmonary infection is treated and secretions must be eliminated. ⋯ Oxygen therapy is given with either a nasal catheter or a mask, according to the patient's need. IPPB and physiotherapy are continued until the patient shows no signs of pulmonary infection and is capable of effectively eliminating secretions. This routine management and extended postoperative respiratory care definitely contribute to the successful outcome of open heart surgery.
-
Anesth Analg (Paris) · Sep 1975
Case Reports[Favorable course of a bilateral postoperative diaphragmatic paralysis].
Writing about a case of post-operative diaphragmatic bilateral palsy (bilateral thoracotomies for oesocoloplasty and oesophagectomy necessited by a caustic oesophagitis) on a 8 years old boy, palsy which was cured 6 months after, the authors tell about causes, prognostic and treatment of diaphragmatic palsies. In that observation, treatment consisted essentially in artificial ventilation for months and a half, and on intensive kinesitherapy.
-
Aberrant psychological behavior has become a frequent occurrence in the intensive care unit (ICU). In specifically considering postcardiotomy psychosis, health professionals puzzle whether the manifestations are motivated by physiological problems imposed by surgical considerations (cardiac status, pump perfusion) and/or by pre- and postoperative psychological factors. Current literature attempts to isolate elements which may predispose patients to develop these aberrant behaviors. This paper attempts to identify important areas and suggest concrete nursing interventions to decrease, delay, and assimilate these behaviors in the cardiotomy patient.
-
Ileostomy function was studied in 12 patients with an established ileostomy following proctocolectomy, in 6 of whom minimal amounts (less than 9 cm) and in 6 significant amounts (30-120 cm, mean 60 cm) of terminal ileum had been removed. Patients who had undergone significant ileal resection had daily faecal volumes considerably greater than those with minimal ileal resection (1202 +/- 284 ml versus 401 +/- 92 ml, P less than 0.001), and also greater daily outputs of sodium (146 +/- 53 mEq versus 43 +/- 12 mEq) and potassium (12.7 +/- 9.0 mEq versus 4.0 +/- 0.99 mEq). ⋯ It is concluded that when recurrent inflammatory bowel disease, partial small bowel obstruction and intraperitoneal sepsis have been excluded there remains a number of patients whose high ileostomy output is due entirely to the amount of ileum resected. The management of patients with a high output ileostomy with codeine phosphate, Lomotil and oral administration of sodium chloride tablets is discussed.