Background The patients having received CABG are more likely to suffer from cardiac dysfunction and hemodynamic instability.Floating catheter provides a full set of hemodynamic parameters in an accurate manner.Methods...Background The patients having received CABG are more likely to suffer from cardiac dysfunction and hemodynamic instability.Floating catheter provides a full set of hemodynamic parameters in an accurate manner.Methods From January 6,2018,to December 29,2018,101 patients receiving CABG in our department were selected.Among them,53 patients indwelt with Swan-Ganz balloon floating catheters.The correct application of indwelling Swan-Ganz balloon floating catheter was analyzed targeting 53 patients receiving CABG to standardize nursing and prevent complications.Results Of the 53 patients recruited,48 cases recovered,3 cases had clinical death,and 2 cases were automatically discharged.There are 16 cases subject to complications and adverse reactions.In 4 cases with catheter obstruction in SICU where CVP could be measured,floating catheters were removed in time within 24 hours after catheterization in 3 cases and 1 d22 h in 1 case.In 2 cases,catheter obstruction happened in SICU after CO measurement and before CVP measurement,where catheter obstruction was observed 1d8h after catheterization,and floating catheters were removed within 2d22h in all cases.There were 3 cases who had capillary hemorrhage at puncture sites,where compression hemostasis with cigarette coils and gauze blocks was performed in all cases,followed by 3M Tegaderm^TM transparent film dressing for sterile covering at the puncture site.4 cases suffered from transient premature ventricular contraction(PVC),which was alleviated without malignant arrhythmia after immediate suspension of operation.In addition,2 cases were subject to balloon catheters in the right ventricle and 1 case had balloon catheter in pulmonary artery,where CO,CI,SVR and other values except for the pulmonary capillary wedge pressure(PCWP)could be measured in all cases.Balloon rupture,pulmonary embolism,pulmonary hemorrhage,and pulmonary artery rupture,catheter knotting and catheter rupture or phlebitis and complications of catheter-related bloodstream infection(CRBI)were not found in the 53 patients.Conclusions The application of Swan-Ganz balloon floating catheter can provide hemodynamic monitoring data and guidance for monitoring the treatment of patients receiving CABG.Scientific application and management of pulmonary artery floating catheters and effective nursing can prevent complications and adverse reactions.展开更多
目的：探讨漂浮导管在非停跳冠状动脉旁路移植术的应用效果。方法选择2011年11月至2014年2月在郑州大学附属郑州中心医院心脏外科诊治的冠状动脉粥样硬化性心脏病（冠心病）患者72例，男性41例，女性31例，年龄45~76岁。随机分为治疗组...目的：探讨漂浮导管在非停跳冠状动脉旁路移植术的应用效果。方法选择2011年11月至2014年2月在郑州大学附属郑州中心医院心脏外科诊治的冠状动脉粥样硬化性心脏病（冠心病）患者72例，男性41例，女性31例，年龄45~76岁。随机分为治疗组（n=36）与对照组（n=36）。所有患者均在全麻下手术，经颈内静脉放置双腔肺动脉漂浮导管监测生命体征，对照组采用常规冠状动脉旁路移植术，治疗组采用非停跳冠状动脉旁路移植术。测定两组肺毛细血管嵌压（PCWP）、中心静脉压（CVP）、心率（HR）等。计算心脏指数（CI）、左心室每搏做功指数（LVSWI）、体循环血管阻力（SVR）。记录两组术中出血量、术中输液量、机械通气时间、ICU停留时间与术后住院时间。结果两组术前、术后即刻和术后12 h PCWP、CVP与HR值对比，差异无统计学意义（P均＞0.05）。两组术后12 h较术前PCWP、CVP和HR均升高，差异有统计学意义（P均＜0.05）。两组术前、术后即刻和术后12 h的CI、LVSWI和SVR值对比，差异无统计学意义（P均＞0.05）。两组术后较术前LVSWI升高，SVR降低，差异有统计学意义（P均＞0.05）。治疗组的机械通气时间、ICU停留时间与术后住院时间明显低于对照组，有统计学差异（P均＜0.05）。两组术中出血量和术中输液量对比差异无统计学意义（P均＞0.05）。结论漂浮导管在非停跳冠状动脉旁路移植术的应用能有效反应心脏的功能状态，值得推广应用。展开更多
基金supported by Guangdong medical science and Technology Research Fund(No.A2017522)
文摘Background The patients having received CABG are more likely to suffer from cardiac dysfunction and hemodynamic instability.Floating catheter provides a full set of hemodynamic parameters in an accurate manner.Methods From January 6,2018,to December 29,2018,101 patients receiving CABG in our department were selected.Among them,53 patients indwelt with Swan-Ganz balloon floating catheters.The correct application of indwelling Swan-Ganz balloon floating catheter was analyzed targeting 53 patients receiving CABG to standardize nursing and prevent complications.Results Of the 53 patients recruited,48 cases recovered,3 cases had clinical death,and 2 cases were automatically discharged.There are 16 cases subject to complications and adverse reactions.In 4 cases with catheter obstruction in SICU where CVP could be measured,floating catheters were removed in time within 24 hours after catheterization in 3 cases and 1 d22 h in 1 case.In 2 cases,catheter obstruction happened in SICU after CO measurement and before CVP measurement,where catheter obstruction was observed 1d8h after catheterization,and floating catheters were removed within 2d22h in all cases.There were 3 cases who had capillary hemorrhage at puncture sites,where compression hemostasis with cigarette coils and gauze blocks was performed in all cases,followed by 3M Tegaderm^TM transparent film dressing for sterile covering at the puncture site.4 cases suffered from transient premature ventricular contraction(PVC),which was alleviated without malignant arrhythmia after immediate suspension of operation.In addition,2 cases were subject to balloon catheters in the right ventricle and 1 case had balloon catheter in pulmonary artery,where CO,CI,SVR and other values except for the pulmonary capillary wedge pressure(PCWP)could be measured in all cases.Balloon rupture,pulmonary embolism,pulmonary hemorrhage,and pulmonary artery rupture,catheter knotting and catheter rupture or phlebitis and complications of catheter-related bloodstream infection(CRBI)were not found in the 53 patients.Conclusions The application of Swan-Ganz balloon floating catheter can provide hemodynamic monitoring data and guidance for monitoring the treatment of patients receiving CABG.Scientific application and management of pulmonary artery floating catheters and effective nursing can prevent complications and adverse reactions.
文摘目的：探讨漂浮导管在非停跳冠状动脉旁路移植术的应用效果。方法选择2011年11月至2014年2月在郑州大学附属郑州中心医院心脏外科诊治的冠状动脉粥样硬化性心脏病（冠心病）患者72例，男性41例，女性31例，年龄45~76岁。随机分为治疗组（n=36）与对照组（n=36）。所有患者均在全麻下手术，经颈内静脉放置双腔肺动脉漂浮导管监测生命体征，对照组采用常规冠状动脉旁路移植术，治疗组采用非停跳冠状动脉旁路移植术。测定两组肺毛细血管嵌压（PCWP）、中心静脉压（CVP）、心率（HR）等。计算心脏指数（CI）、左心室每搏做功指数（LVSWI）、体循环血管阻力（SVR）。记录两组术中出血量、术中输液量、机械通气时间、ICU停留时间与术后住院时间。结果两组术前、术后即刻和术后12 h PCWP、CVP与HR值对比，差异无统计学意义（P均＞0.05）。两组术后12 h较术前PCWP、CVP和HR均升高，差异有统计学意义（P均＜0.05）。两组术前、术后即刻和术后12 h的CI、LVSWI和SVR值对比，差异无统计学意义（P均＞0.05）。两组术后较术前LVSWI升高，SVR降低，差异有统计学意义（P均＞0.05）。治疗组的机械通气时间、ICU停留时间与术后住院时间明显低于对照组，有统计学差异（P均＜0.05）。两组术中出血量和术中输液量对比差异无统计学意义（P均＞0.05）。结论漂浮导管在非停跳冠状动脉旁路移植术的应用能有效反应心脏的功能状态，值得推广应用。
