Document Detail


The surgeon's response to a low-output state after cardiopulmonary bypass: etiologies and remedies.
MedLine Citation:
PMID:  2133853     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Following cardiopulmonary bypass, a series of steps can usually be used to restore function to the heart. A low postbypass cardiac output can be countered with a response checklist that includes adjusting heart rate, correcting cardiac arrhythmia, ensuring adequate hematocrit, adjusting preload and afterload, and stimulating cardiac contractility. It is the surgeon's responsibility to make a thorough investigation of any structural abnormality that may contribute to the low-output state; adequate repair of cardiac defects will often result in an improved hemodynamic state. Hemorrhage is an important cause of poor cardiac performance. Tamponade of the heart is usually due to retained clots associated with hemorrhage after operation and is indicated by a low-output state with equalization and elevation of atrial pressures. In a low-output, postsurgical state, the possibility of residual shunts and obstructions, inadequate valve repair, and closure or inadequate flow through a graft may need to be investigated. Once that has been achieved, the appropriate steps can be taken to improve cardiac performance.
Authors:
D B Doty
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  5     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:  1990 Sep 
Date Detail:
Created Date:  1992-04-09     Completed Date:  1992-04-09     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  256-8     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Utah School of Medicine, Salt Lake City.
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MeSH Terms
Descriptor/Qualifier:
Arrhythmias, Cardiac / etiology,  therapy
Blood Loss, Surgical
Cardiac Output, Low / etiology*,  therapy*
Cardiac Surgical Procedures* / adverse effects
Cardiac Tamponade / etiology,  therapy
Cardiopulmonary Bypass / adverse effects*
General Surgery
Heart / physiopathology
Heart Rate / physiology
Humans
Myocardial Contraction / physiology
Postoperative Complications

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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