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Related Concept Videos

Jaundice01:25

Jaundice

Jaundice, or icterus, is the yellow discoloration of the skin, sclerae, and mucous membranes. It happens when plasma bilirubin levels rise above 2.5-3 mg/dL, leading to bilirubin deposition in tissue.Bilirubin is a byproduct of hemoglobin degradation. In macrophages, hemoglobin breaks down into globin and heme. Globin is converted into amino acids, while heme is turned into biliverdin by heme oxygenase, which is then reduced to unconjugated bilirubin by biliverdin reductase.Unconjugated...
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
Diseases of the Liver and Gallbladder01:26

Diseases of the Liver and Gallbladder

Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not related to...
Cardiac Catheterization IV: Nursing Management01:26

Cardiac Catheterization IV: Nursing Management

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Aneurysm IV: Nursing Management

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Related Experiment Videos

Postoperative jaundice after cardiac surgery.

Aikaterini Mastoraki1, Emmanouil Karatzis, Sotiria Mastoraki

  • 1Department of Surgical Intensive Care Unit, Onassis Cardiac Surgery Center, 356 Sygrou Ave, 17674 Athens, Greece. dr_kamast@yahoo.gr

Hepatobiliary & Pancreatic Diseases International : HBPD INT
|August 11, 2007
PubMed
Summary

Postoperative jaundice (hyperbilirubinemia) occurred in 26.5% of open-heart surgery patients. This complication was linked to longer surgery times, specific procedures like mitral valve replacement, and patient factors such as heart failure.

Related Experiment Videos

Area of Science:

  • Cardiology
  • Hepatology
  • Surgical Intensive Care

Background:

  • Postoperative jaundice following open-heart surgery lacks clear understanding regarding its frequency, pattern, and complications.
  • The clinical significance of jaundice, including associated morbidity and mortality, requires further investigation.

Purpose of the Study:

  • To determine the incidence and characteristics of jaundice after cardiac operations.
  • To identify factors influencing postoperative jaundice.
  • To assess the clinical impact of jaundice on patient outcomes.

Main Methods:

  • A prospective observational study involving 128 adult patients undergoing open-heart surgery between 2003-2004.
  • Patients were categorized into three groups: coronary artery bypass grafting (CABG), aortic valve replacement (AVR)+CABG, and mitral valve replacement (MVR)+CABG.
  • Serum bilirubin and liver enzymes were monitored, with jaundice defined as serum bilirubin >3 mg/dl.

Main Results:

  • Hyperbilirubinemia developed in 34 patients (26.5%), with a higher incidence in the MVR+CABG group.
  • Jaundice correlated significantly with prolonged cardiopulmonary bypass, aortic cross-clamping times, intra-aortic balloon pump use, inotropic support, and blood transfusions.
  • The jaundice observed was primarily due to elevated conjugated bilirubin levels.

Conclusions:

  • Postoperative jaundice in cardiac surgery patients is multifactorial.
  • Key determinants include the type of surgical procedure (e.g., MVR+CABG), preoperative hepatic dysfunction (NYHA II-III heart failure), and reduced hepatic blood flow during surgery.