Abstract

The problem of this study was to review 100 open heart surgical cases in a selected hospital to determine the changes occurring in central venous pressure in relation to blood loss.

The review of literature revealed that central venous pressure is an important factor in determining immediate postoperative care of open heart surgical patients. If central venous pressure falls below the normal range of 5 to 10 centimeters of water, hemorrhage is suspected. If central venous pressure is elevated between 15 and 20 centimeters of water, cardiac tamponade is suspected.

The descriptive survey method of research was used. Medical records of 100 patients having open heart surgery from January 1, 1962 through December 31, 1963 in a selected hospital were reviewed.

All cases studied were grouped according to blood loss. Those comprising Group I had a blood loss of less than 1000 ml. during the first twenty postoperative hours. This was considered to be within normal limits for the study. Group II had a blood loss that exceeded 1000 ml. during this same period of time.

Group I was composed of 77 of the 100 cases included in the study. This group had no apparent complications involving blood loss. Fifty-three of the 77 showed normal mean central venous and arterial pressures and blood loss following open heart surgery, Twenty-four varied to a slight degree from the normal central venous pressure; 16 had central venous pressure measurements which ranged from 9 to 14, thus slightly exceeding the upper limit of normal; 8 had central venous pressure ranging from 2 to 6, thus slightly falling below the level of normal. Because all 77 apparently had no complications involving blood loss and the central venous pressure readings approximated the accepted normal, it was concluded that normal blood loss for this group tended to be accompanied by normal central venous pressure.

Group II consisted of 23 patients whose blood loss exceeded 1000 ml. during the first twenty hours postoperatively. An excessive amount of high blood loss tended to be accompanied by high central venous pressure if blood was pooling in the chest cavity or pericardium.

Because of complications involving hemorrhage, 7 patients were returned to surgery for reoperation. Of these, 6 had central venous pressure measurements that exceeded the normal range to some degree. Three of the patients had large amounts of blood pooling in the chest, while 3 had blood and clots in the pericardium. One patient had a typically low central venous pressure.

Since the 23 cases with excessive bleeding were approximately equally divided between valve surgeries and septal defect repairs, it was concluded that the type of open heart surgery was not a determining factor in severity of hemorrhage. A larger percentage of adults than children had increased blood loss.

The findings in the study agreed with the hypothesis that central venous pressure is a sensitive index of hemorrhage following open heart surgery.

LLU Discipline

Nursing

Department

Nursing

School

Graduate School

First Advisor

Winifred Edwards

Second Advisor

Lucile Lewis

Third Advisor

Ellsworth E. Wareham

Degree Name

Master of Science (MS)

Degree Level

M.S.

Year Degree Awarded

1964

Date (Title Page)

6-1964

Language

English

Library of Congress/MESH Subject Headings

Heart Surgery; Central Venous Pressure

Type

Thesis

Page Count

vii; 77

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

Download

Share

COinS