The Tests And Procedures To Be Able To Identify The Type Of Shock After Cardiac Surgery
A patient who is 48 hours post mitral valve surgery replacement when they tend to be more tachycardic,hypotensive,tachypneic and restless the patient could be going back to either or both septic or cardiogenic shock .The following are the tests and procedures to be able to identify the type of shock;
There are postoperative shocks that occur in a patient after cardiac surgery that is a serious condition with high mortality and morbidity. Most four common shocks are cardiogenic ,obstructractive ,hypovolemic and distributive. They can occur in combination or alone. Early identification of the existing disease and understanding the mechanisms at work to successfully understand the shock. There are prompt measures of resuscitation to reverse the shock and avoid death or permanent organ dysfunction.
When a patient suffer from low cardiac preload that is tamponade or bleedind.Failure to pumb that is myocardial infarction,mechanical complication or stunning ,then the patient in this case is suffering from cardiogenic ,obstructive or hypovolemic shock.But damages that are molecular patterns associated (DAMPS)injured tisuue and molecular patterns associated.(PAMPS)an infenction activating inflammatory cascade .Then if untreated the condition leads to vicious cycle that can cause distributive shock,death or failure of multiple organs(MOF).
For the treatment when the shock is identified, correcting measure of the underling mechanisms and cause at done for recovery. Simultaneously, measures of prompt resuscitation are undertaken to allow sufficient oxygen delivery and prevent more damage to organs.Tissue oxygenation is sufficient when oxygen delivery and consumption are balanced.For the patient with myocardial contractility consider ECLS for those who do not respond to support of pharmacological inotropic
Surgery for mitral valve surgery is associated with high operative morbidity,mortality therefore making very challenging .Shock,impaired ventricular to function,age,endocartitis of prosthetic valve,and multiple infections will impact the survival of the patient for long.
Reference.
David, T. E., Gavra, G., Feindel, C. M., Regesta, T., Armstrong, S., & Maganti, M. D. (2007). Surgical treatment of active infective endocarditis: a continued challenge. The Journal of thoracic and cardiovascular surgery, 133(1), 144-149.
Hauffe, T., Krüger, B., Bettex, D., & Rudiger, A. (2015). Shock management for cardio-surgical ICU patients–the golden hours. Cardiac Failure Review, 1(2), 75.