Profile and anaesthetic management following stabbed hearts: a one year retrospective review

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.