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Fluid and electrolyte imbalances after cardiac surgery.
AACN Clinical Issues in Critical Care Nursing
|August 1, 1992
Summary
Cardiac surgery, particularly cardiopulmonary bypass (CPB), causes significant fluid and electrolyte imbalances. This review details these iatrogenic metabolic alterations and their therapeutic interventions.
Area of Science:
- Cardiovascular Surgery
- Nephrology
- Critical Care Medicine
Background:
- Cardiac surgery frequently leads to complex fluid and electrolyte disturbances.
- Cardiopulmonary bypass (CPB) induces numerous physiological changes impacting homeostasis.
- These alterations include electrolyte imbalances, acid-base disturbances, and renal function changes.
Purpose of the Study:
- To describe the metabolic alterations iatrogenically induced by cardiac surgery.
- To outline nursing and medical therapies for correcting these alterations.
Main Methods:
- Review of physiological changes associated with cardiac surgery and CPB.
- Discussion of the impact of cardioplegia, hypothermia, surgical stress, and fluid resuscitation on metabolic balance.
- Analysis of CPB-induced alterations in renal function.
Main Results:
- CPB causes electrolyte disturbances, acid-base imbalances, and hemolysis.
- Hypothermia and cardioplegic solutions affect potassium metabolism and pH.
- Surgical stress increases catecholamines and antidiuretic hormone, altering fluid balance.
- Fluid resuscitation and nonpulsatile CPB flow contribute to metabolic and renal dysfunction.
Conclusions:
- Cardiac surgery and CPB are associated with a wide range of iatrogenic metabolic derangements.
- Effective nursing and medical management are crucial for correcting these postoperative complications.
- Understanding these alterations is key to optimizing patient recovery and outcomes.