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


OBJECTIVE
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.


CONCLUSIONS
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.
Currey
Judy
J
Alfred/Deakin Nursing Research Centre, Deakin University, 221 Burwood Highway, Burwood Victoria 3125, Australia. curreyj@deakin.edu.au
Botti
Mari
M
D000368:Aged; D002303:Cardiac Output, Low / Q000175:diagnosis / Q000451:nursing; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000451:nursing / Q000601:surgery; D003422:Critical Care / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000451:nursing*; D009730:Nursing Assessment; D011183:Postoperative Complications / Q000175:diagnosis / Q000451:nursing*; D011184:Postoperative Period; D011997:Recovery Room; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome