Journal article
Excessive bleeding predictors after cardiac surgery in adults: integrative review
Journal of clinical nursing, Vol.24(21-22), pp.3046-3062
11/2015
DOI: 10.1111/jocn.12936
PMID: 26249656
Abstract
To integrate literature data on the predictors of excessive bleeding after cardiac surgery in adults.
Perioperative nursing care requires awareness of the risk factors for excessive bleeding after cardiac surgery to assure vigilance prioritising and early correction of those that are modifiable.
Integrative literature review.
Articles were searched in seven databases. Seventeen studies investigating predictive factors for excessive bleeding after open-heart surgery from 2004-2014 were included.
Predictors of excessive bleeding after cardiac surgery were: Patient-related: male gender, higher preoperative haemoglobin levels, lower body mass index, diabetes mellitus, impaired left ventricular function, lower amount of prebypass thrombin generation, lower preoperative platelet counts, decreased preoperative platelet aggregation, preoperative platelet inhibition level >20%, preoperative thrombocytopenia and lower preoperative fibrinogen concentration. Procedure-related: the operating surgeon, coronary artery bypass surgery with three or more bypasses, use of the internal mammary artery, duration of surgery, increased cross-clamp time, increased cardiopulmonary bypass time, lower intraoperative core body temperature and bypass-induced haemostatic disorders. Postoperative: fibrinogen levels and metabolic acidosis.
Patient-related, procedure-related and postoperative predictors of excessive bleeding after cardiac surgery were identified.
The predictors summarised in this review can be used for risk stratification of excessive bleeding after cardiac surgery. Assessment, documentation and case reporting can be guided by awareness of these factors, so that postoperative vigilance can be prioritised. Timely identification and correction of the modifiable factors can be facilitated.
Details
- Title: Subtitle
- Excessive bleeding predictors after cardiac surgery in adults: integrative review
- Creators
- Camila Takao Lopes - School Hospital, São Paulo University (HU-USP), São Paulo, SP, BrazilTalita Raquel Dos Santos - School of Nursing, São Paulo University (EEUSP), São Paulo, SP, BrazilEvelise Helena Fadini Reis Brunori - ICU I, Dante Pazzanese Cardiology Institute (IDPC), São Paulo, SP, BrazilSue A Moorhead - College of Nursing, The University of Iowa, Iowa City, IA, USAJuliana de Lima Lopes - Paulista Nursing School, Federal University of São Paulo (EPE-UNIFESP), São Paulo, SP, BrazilAlba Lucia Bottura Leite de Barros - Paulista Nursing School, Federal University of São Paulo (EPE-UNIFESP), São Paulo, SP, Brazil
- Resource Type
- Journal article
- Publication Details
- Journal of clinical nursing, Vol.24(21-22), pp.3046-3062
- Publisher
- England
- DOI
- 10.1111/jocn.12936
- PMID
- 26249656
- ISSN
- 0962-1067
- eISSN
- 1365-2702
- Grant note
- DOI: 10.13039/501100002322, name: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior; DOI: 10.13039/501100003593, name: Conselho Nacional de Desenvolvimento Científico e Tecnológico
- Language
- English
- Date published
- 11/2015
- Academic Unit
- Nursing
- Record Identifier
- 9984064157102771
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