The haemodynamic status of cardiac surgical patients in the initial 2-h recovery period

Abstract

Background: Critical care nurses caring for cardiac patients in the immediate postoperative period continually make decisions about the implications and treatment of their patients' haemodynamic status.

Aim: The aim of this study was to describe the haemodynamic status of patients on admission to critical care and over the 2-h period following cardiac surgery.

Methods: A quantitative, descriptive design was used. Data were collected using non-participant observation and an observation tool. The sample consisted of 38 patients.

Results: Analysis of data revealed the dynamic nature of the haemodynamic status of postoperative cardiac patients. On admission, 60% of patients (n=23) were haemodynamically unstable. The instability in these patients (n=23) was due to hypotension (34%), bleeding (21%) and hypoxaemia (18%). During the 2-h recovery period, 55% of patients were hypotensive, 16% of patients had low cardiac output syndrome and 16% of patients had low systemic vascular resistance (SVR) syndrome. Twenty-one percent of patients experienced bleeding complications. Shivering was a clinically significant problem in terms of occurrence (23%) and duration (X=45, S.D.=30 min). Twenty-nine percent of patients (n=11) had a profound deterioration in haemodynamic status, necessitating urgent interventions.

Conclusion: Haemodynamic parameters indicate that 95% of patients in this study were haemodynamically unstable at some time during the initial 2-h recovery period. These findings inform resourcing decisions by organisations and have implications for nurses' assessment and interventional haemodynamic decision making.