RESUMEN
Hemodynamic and intravascular volume monitoring has been utilized and significantly improved thanks to the technology revolution. Goal-Directed Therapy (GDT) derived from this advanced monitoring is beneficial for complex surgeries, and it shifted the medical approaches from static therapy to more personalized functional treatments. Conventional monitoring methods such as blood pressure, heart rate, urinary output, and central venous pressure are commonly used. However, studies have shown these routine parameters often cannot precisely estimate the quality of tissue perfusion. Tissue hypoperfusion and hypoxia play a crucial role in initiating a systemic inflammatory response after prolonged surgeries, resulting in unstable hemodynamic condition of the patients. Several studies reported the importance of GDT in non-cardiac surgeries and there are few reports on cardiac surgeries. However, tissue perfusion and fluid management are more critical in complex and prolonged cardiovascular surgeries to avoid complications such as low cardiac output syndrome and renal or pulmonary dysfunction. Different advanced hemodynamic monitorings have been utilized perioperatively in cardiac surgery to help decision-making on inotrope and fluid management. In this article we present 5 cases of usefulness hemodynamic monitoring in patients who underwent cardiovascular surgeries.
RESUMEN
Background: The aim of the present study was to investigate the effect of heparin (1000 IU/mL) in the blood sample on the results of venous blood gases of patients admitted to the cardiac intensive care unit. Materials and methods: The present double-blind randomized clinical trial study was performed on 282 samples from 141 patients admitted to the cardiac intensive care unit. Insulin syringes with heparin (1000 IU/mL) and heparin (5000 IU/mL) and 1 cc of blood sample were taken from the peripheral vein, then distributed in two syringes and given to the analyzer. Results: In the present study, the mean age of the samples was 49.96 ± 9.58. There was a statistically significant difference between the two groups in terms of values of partial pressure of carbon dioxide (PCO2) (P < 0.001), partial pressure of oxygen (PaO2) (P < 0.001), blood oxygen saturation (P < 0.001), bicarbonate ion (P < 0.001), excess base (P < 0.001), hemoglobin (P < 0.001), calcium (P < 0.001), potassium (P < 0.001), and sodium (P < 0.001) in the two groups. Conclusion: Overall, heparin (1000 IU/mL) led to a less disruption in the results of venous blood gases, and since it has not significantly increased the risk of clots, it is recommended to be used for venous blood gas sampling.