[Clinical analysis of gastrointestinal bleeding after cardiac surgery].
OBJECTIVE
To explore early diagnosis, treatment and prevention of gastrointestinal (GI) bleeding after cardiac surgery.


METHODS
In the last 13 years, cases complicated with GI bleeding after cardiac surgeries were analyzed retrospectively.


RESULTS
Fourty-four GI bleeding occurred post-operatively in (6 +/- 3) d. The mortality was 23% (10/44). Thirty-eight were located in upper GI tract, of them 26 underwent conservative therapy while 4 died of other than GI bleeding cause; six underwent laparotomy while 1 and 3 died of septicemia and multi-organ failure respectively; six underwent gastric endoscopic hemostasis by electrocautery or clipping the bleeding vessel while all survived. Six were located in lower GI tract, and 2 of them underwent laparotomy without finding bleeding section and died of multi-organ failure. By multivariable logistic regression analysis, deaths were highly related to the post-operative ventilator-dependence, acute renal insufficiency, intra-aortic balloon pump (IABP) assisting and laparotomy.


CONCLUSIONS
The mortality of GI bleeding after cardiac surgeries is very high, early gastrointestinal endoscopic examination and minimally invasive intervention can treat this complication more effectively. GI bleeding must be prevented whenever complicating post-operative ventilator-dependence, acute renal insufficiency, and IABP assisting after cardiac surgery.
Guo
Hui-ming
HM
Department of Cardiac Surgery, Guangdong Provincial Cardiovascular Institute, Guangzhou 510100, China. guohuiming@163.net
Wu
Ruo-bin
RB
Yang
Hong-wei
HW
Zheng
Shao-yi
SY
Fan
Rui-xin
RX
Lu
Cong
C
Zhang
Jing-fang
JF
D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D042241:Early Diagnosis; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors