Premium
Factors associated with the increased bleeding in the postoperative period of cardiac surgery: A cohort study
Author(s) -
Pereira Kárla M. F. S. M.,
Assis Caroline S.,
Cintra Haulcionne N. W. L.,
FerrettiRebustini Renata Eloah L.,
Püschel Vilanice A. A.,
SantanaSantos Eduesley,
Rodrigues Adriano Rogério B.,
Oliveira Larissa B.
Publication year - 2019
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.14670
Subject(s) - medicine , cardiac surgery , partial thromboplastin time , metabolic acidosis , cardiopulmonary bypass , body mass index , prospective cohort study , cardiac index , anesthesia , surgery , heart rate , platelet , blood pressure
Aims and objectives To identify factors associated with the increased bleeding in patients during the postoperative period after cardiac surgery. Background Bleeding is among the most frequent complications that occur in the postoperative period after cardiac surgery, representing one of the major factors in morbidity and mortality. Understanding the factors associated with the increased bleeding may allow nurses to anticipate and prioritise care, thus reducing the mortality associated with this complication. Design Prospective cohort study. Methods Adult patients in a cardiac hospital who were in the postoperative period following cardiac surgery were included. Factors associated with the increased bleeding were investigated by means of linear regression, considering time intervals of 6 and 12 hr. Results The sample comprised 391 participants. The factors associated with the increased bleeding in the first 6 hr were male sex, body mass index, cardiopulmonary bypass duration, anoxia duration, metabolic acidosis, higher heart rate, platelets and the activated partial thromboplastin time in the postoperative period. Predictors in the first 12 hr were body mass index, cardiopulmonary bypass duration, metabolic acidosis, higher heart rate, platelets and the activated partial thromboplastin time in the postoperative. Conclusions This study identified factors associated with the increased postoperative bleeding from cardiac surgery that have not been reported in previous studies. The nurse is important in the vigilance, evaluation and registry of chest tube drainage and modifiable factors associated with the increased bleeding, such as metabolic acidosis and postoperative heart rate, and in discussions with the multiprofessional team. Relevance to clinical practice Knowledge of the factors associated with the increased bleeding is critical for nurses so they can provide prophylactic interventions and early postoperative treatment when needed.