Why the study?
How do postoperative haemodynamics differ between patients with and without cardiac disease following major vascular surgery?
How do postoperative haemodynamics differ between patients with and without cardiac disease following major vascular surgery?
Patients with cardiac disease exhibit a blunted haemodynamic response to major vascular surgery compared to those without cardiac disease, though preoperative differences can be managed with central pressure-guided therapy.
Answers are grounded in this paper and cite their sources.
Differential haemodynamic responses by cardiac status after vascular surgery require cautious interpretation; leaves open whether guided therapy improves outcomes.
The cardiovascular reaction to primarily major vascular surgery was examined in 39 patients without cardiac disease and in 11 patients with cardiac disease. In the immediate postoperative period (24 h), patients without cardiac disease showed significant increases in heart rate and cardiac index and a decreased blood volume. The central pressures were increased during the first postoperative hour. Systemic blood pressure and vascular resistance remained unchanged, or decreased slightly. Postoperative haemodynamics in patients with cardiac disease followed the same trends as in normal patients; there were, however, no significant changes in cardiac index or central pressures, and in general the cardiovascular reaction to operation was less conspicuous than in the group of normal patients. The preoperative haemodynamic differences between the two groups were diminished in the immediate postoperative period because therapy could be guided by measuring central pressures.
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Sørensen et al. (1978) studied this question.
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