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Reexploration for Bleeding and Tamponade in Intensive Care Unit Following Open Heart Surgery [Anatol J Cardiol]
Anatol J Cardiol. 2004; 4(1): 19-22

Reexploration for Bleeding and Tamponade in Intensive Care Unit Following Open Heart Surgery

Mehmet Ali Özatik1, Kamil Göl2, Baran Budak3, Şeref Küçüker4, Ahmet Sarıtaş5, Binali Mavitaş6, Erol Şener4, Oğuz Taşdemir1
1Türkiye Yüksek İhtisas Hastanesi Kalp Damar Cerrahisi Kliniği, Ankara, Türkiye
2Department of Cardiovascular Surgery Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
3Türkiye Yüksek ihtisas Hastanesi, Kardiyoloji Kliniği, Ankara, Türkiye
4Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, Ankara
5Türkiye Yüksek İhtisas Hastanesi Kalp ve Damar Cerrahisi Kliniği, Sıhhiye, Ankara, Türkiye
6Department of Cardiovascular Surgery, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey

Objective: Following open heart surgery some patients can need reexploration in the intensive care unit due to bleeding or pericardial tamponade. This study evaluates the impact of reexploration in the intensive care unit (ICU) on morbidity and mortality rates. Methods: Between January 1990 and January 2002 overall 18578 open heart surgery procedures were performed in our clinic and among them 570 (3%) patients required reexploration due to bleeding or pericardial tamponade. Reexplorations were done in the operating room (OR) in 385 (67.5%) patients and in the ICU in 185 (32.5%) patients. Results: Among patients 383(67.2%) were male and 187(32.8%) were female. Mean age for reexploration in the OR group was 46.9±16.3 years, and in the ICU group was 48.2±15.7 years. The use of fresh frozen plasma and bank blood was significantly higher in the ICU group (p<0.0001). Fifty patients (27%) who were reexplored in ICU had intraaortic balloon pump (IABP) support (p<0.0001). Sixty six patients (%17.1) died in OR group and 70 patients (37.8%) died in the ICU group (p<0.001). Following reexploration, 24 (6.2%) patients in the OR group and 17 (9.1%) patients in the ICU group had major infection (p>0.05). There was no statistically significant difference among groups in hospital stay time. Conclusion: Following open heart surgery, especially among hemodynamically unstable patients, to avoid possible problems of transfer to the OR and time lost, reexplorations can be done in ICU. This practice does not increase morbidity and hospital stay.

Keywords: Intensive care unit, bleeding, pericardial tamponade, reexploration


Açık Kalp Ameliyatları Sonrası Kanama veya Tamponad Nedeniyle Yoğun Bakımda Yapılan Reeksplorasyonlar

Mehmet Ali Özatik1, Kamil Göl2, Baran Budak3, Şeref Küçüker4, Ahmet Sarıtaş5, Binali Mavitaş6, Erol Şener4, Oğuz Taşdemir1
1Türkiye Yüksek İhtisas Hastanesi Kalp Damar Cerrahisi Kliniği, Ankara, Türkiye
2Department of Cardiovascular Surgery Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
3Türkiye Yüksek ihtisas Hastanesi, Kardiyoloji Kliniği, Ankara, Türkiye
4Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, Ankara
5Türkiye Yüksek İhtisas Hastanesi Kalp ve Damar Cerrahisi Kliniği, Sıhhiye, Ankara, Türkiye
6Department of Cardiovascular Surgery, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey

Anahtar Kelimeler: Yoğun bakım, kanama, perikardiyal tamponad, re-eksplorasyon


Mehmet Ali Özatik, Kamil Göl, Baran Budak, Şeref Küçüker, Ahmet Sarıtaş, Binali Mavitaş, Erol Şener, Oğuz Taşdemir. Reexploration for Bleeding and Tamponade in Intensive Care Unit Following Open Heart Surgery. Anatol J Cardiol. 2004; 4(1): 19-22


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