Our Summary

This research paper describes a survey of how doctors in the United States use oxygen during heart surgery. The study surveyed over 500 healthcare providers, including heart anesthesiologists and perfusionists (experts who manage the heart-lung machine during surgery).

The survey asked about how much oxygen these doctors use during different parts of heart surgery. The responses showed that perfusionists and anesthesiologists have different opinions about how much oxygen is the right amount during surgery.

Perfusionists, on average, aim for higher levels of oxygen in the patient’s blood than anesthesiologists do. They also consider lower levels of oxygen to be “too low” than anesthesiologists do. On the other hand, anesthesiologists are more comfortable with lower levels of oxygen and consider higher levels of oxygen to be less desirable than perfusionists do.

The study concluded that there is a lot of variation in how much oxygen doctors use during heart surgery. They also found that using more oxygen than necessary, known as hyperoxygenation, was more common while the heart-lung machine was being used during surgery.

FAQs

  1. What was the purpose of the survey conducted in the research study about cardiac surgery?
  2. What differences were found between perfusionists and anesthesiologists in terms of oxygen use during heart surgery?
  3. What is hyperoxygenation and when was it found to be more common during heart surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about cardiac surgery is to discuss the use of oxygen during the procedure. It is important for patients to understand that there may be variability in how much oxygen is used during different stages of the surgery, and that doctors may have different opinions on the optimal levels of oxygen. Patients should feel comfortable asking their healthcare providers about the use of oxygen during their surgery and how it may impact their recovery.

Suitable For

Patients who are typically recommended for cardiac surgery include those with severe coronary artery disease, heart valve disease, congenital heart defects, and heart failure. These patients may experience symptoms such as chest pain, shortness of breath, fatigue, and swelling in the legs or abdomen. Additionally, patients with a history of heart attacks, arrhythmias, or other heart-related conditions may also be recommended for cardiac surgery. Ultimately, the decision to undergo cardiac surgery is based on the patient’s individual condition and risk factors, and is determined by a team of healthcare providers including cardiologists, cardiac surgeons, and other specialists.

Timeline

Before cardiac surgery:

  • Patient undergoes pre-operative evaluation and testing to assess their overall health and readiness for surgery
  • Patient meets with their healthcare team to discuss the procedure, risks, and benefits
  • Patient may need to make lifestyle changes, such as quitting smoking or adjusting medications, to optimize their health before surgery
  • Patient may need to fast before surgery and follow specific instructions from their healthcare team

During cardiac surgery:

  • Patient is taken to the operating room and given anesthesia to induce a state of unconsciousness
  • Surgeon performs the necessary procedures, such as bypass surgery or valve replacement, on the heart
  • Patient is connected to a heart-lung machine, which takes over the function of the heart and lungs during surgery
  • Anesthesia and monitoring equipment are used to ensure the patient’s safety throughout the procedure

After cardiac surgery:

  • Patient is transferred to the recovery room or intensive care unit for close monitoring
  • Patient may need to stay in the hospital for several days to recover and receive post-operative care
  • Patient may experience pain, fatigue, and other side effects of surgery
  • Patient will work with their healthcare team to develop a plan for rehabilitation and recovery, including physical therapy and lifestyle changes to improve heart health

Overall, the timeline for a patient before and after cardiac surgery involves thorough preparation, careful monitoring during the procedure, and comprehensive post-operative care to ensure a successful outcome.

What to Ask Your Doctor

Some questions a patient should ask their doctor about cardiac surgery include:

  1. What are the potential risks and complications associated with this specific type of cardiac surgery?
  2. What is the expected outcome of the surgery, and what is the recovery process like?
  3. How experienced are you in performing this type of cardiac surgery?
  4. What alternatives to surgery are available, and why is surgery the recommended treatment in my case?
  5. What type of anesthesia will be used during the surgery, and what are the potential side effects or risks associated with it?
  6. How long will the surgery take, and how long will I need to stay in the hospital afterwards?
  7. Will I need to be placed on a heart-lung machine during the surgery, and if so, how will my oxygen levels be monitored and controlled?
  8. What is the plan for pain management after the surgery?
  9. What are the long-term effects or considerations I should be aware of after undergoing this surgery?
  10. What is the success rate of this type of surgery, and what is the likelihood of needing additional procedures in the future?

Reference

Authors: Calhoun A, Pannu A, Mueller AL, Elmadhoun O, Valencia JD, Krajewski ML, O’Gara BP, Katsiampoura A, O’Connor ST, Chu L, Monteith E, Shankar P, Spear K, Shaefi S. Journal: J Cardiothorac Vasc Anesth. 2022 Aug;36(8 Pt B):2917-2926. doi: 10.1053/j.jvca.2022.01.019. Epub 2022 Jan 19. PMID: 35227576