Profile and anaesthetic management following stabbed hearts: a one year retrospective review
Date
2016
Authors
Abraham, Siju Joseph
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Stabbed hearts are surgical emergencies that require a prompt and focused anaesthetic
intervention. The aim of this study was to describe the profile and anaesthetic
management of patients with stabbed hearts presenting to the Diepkloof Mortuary and
Chris Hani Baragwanath Academic Hospital during a one year period.
A retrospective, contextual and descriptive design, with consecutive convenience
sampling was used.
There were 44 patients with stabbed hearts; most were males (93%), between 20 and 29
years (53%), and stabbed in the right ventricle (63%); 48% survived to hospital admission.
Of those 90% survived to receive surgical management in theatre. Seventy-four percent
were intubated in theatre. Most patients were induced with etomidate (58%),
suxamthonium (41%) or rocuronium (35%), and fentanyl (88%). Arterial lines (71%) and
central venous catheters (76%) were frequently inserted. Fluid resuscitation with blood
products or cell salvage (76%), colloids (70%) and crystalloids (70%) were used.
Postoperatively, 89% of the patients were alive, 47% were still intubated and transferred
to ICU.
Mainly young males were the victims of stabbed hearts. Almost half of the victims survived
to hospital admission. Most patients were intubated in theatre following rapid or modified
rapid sequence induction, had arterial lines and central venous catheters inserted, and
received blood products. Eighty-nine percent of patients survived to theatre discharge.
Description
A research report submitted to the Faculty of Health Sciences,
University of the Witwatersrand, in partial fulfilment of the requirements
for the degree
of
Master of Medicine in branch of Anaesthesiology
Johannesburg, 2016