Our Summary

This study looked at the impact of intraoperative fluid management (how much fluid is given to a patient during surgery) on patients with constrictive pericarditis (a condition where the sac around the heart becomes hardened and constricts the heart) who are undergoing pericardiectomy (surgery to remove the sac around the heart).

The researchers divided 92 patients into two groups based on how much fluid they were given during surgery - the ‘restrictive’ group, who were given less fluid, and the ’liberal’ group, who were given more fluid. They then compared the post-surgery outcomes of both groups.

The findings revealed that patients in the ‘restrictive’ group had a lower rate of post-surgery complications, including heart-related complications. They also spent less time in the hospital after surgery.

The study concluded that for patients with constrictive pericarditis undergoing pericardiectomy, a restrictive fluid management strategy during surgery (giving less fluid) is associated with better post-surgery outcomes and a faster recovery. Therefore, it is suggested as the preferred approach for managing fluid during this type of surgery.

FAQs

  1. What is the impact of intraoperative fluid management on patients with constrictive pericarditis undergoing pericardiectomy?
  2. What were the post-surgery outcomes for patients given different amounts of fluid during pericardiectomy?
  3. Why is a restrictive fluid management strategy recommended for patients with constrictive pericarditis undergoing pericardiectomy?

Doctor’s Tip

A helpful tip a doctor might give a patient about pericardiectomy is to follow a restrictive fluid management strategy during surgery to improve post-surgery outcomes and speed up recovery. It is important for patients to discuss this with their healthcare provider and understand the potential benefits of this approach.

Suitable For

Patients with constrictive pericarditis who are undergoing pericardiectomy are typically recommended for this surgery. Symptoms of constrictive pericarditis may include shortness of breath, fatigue, swelling in the legs or abdomen, and chest pain. Patients who have failed medical management or who have severe symptoms that significantly impact their quality of life may be recommended for pericardiectomy. Additionally, patients who have developed complications such as heart failure or recurrent pericarditis may also be candidates for this surgery.

Timeline

Timeline of what a patient experiences before and after pericardiectomy:

Before pericardiectomy:

  • Patient presents with symptoms of constrictive pericarditis, such as shortness of breath, chest pain, and fatigue.
  • Diagnostic tests, such as echocardiogram, MRI, and CT scans, are performed to confirm the diagnosis.
  • Patient is evaluated by a cardiac surgeon to determine if pericardiectomy is necessary.
  • Pre-operative tests and evaluations are conducted to assess the patient’s overall health and readiness for surgery.

During pericardiectomy:

  • Patient undergoes surgery to remove the hardened sac around the heart.
  • Intraoperative fluid management is carefully monitored, with some patients receiving a restrictive fluid strategy and others receiving a liberal fluid strategy.

After pericardiectomy:

  • Patient is closely monitored in the intensive care unit (ICU) for a period of time to ensure stability.
  • Post-surgery complications, such as arrhythmias or infection, are monitored and managed.
  • Patient may undergo cardiac rehabilitation to aid in recovery and improve heart function.
  • Follow-up appointments are scheduled to assess the patient’s progress and overall health post-surgery.

Overall, the timeline for a patient before and after pericardiectomy involves careful evaluation, surgery, and post-operative care to ensure a successful outcome and optimal recovery.

What to Ask Your Doctor

  1. How will the amount of fluid I receive during surgery be determined?
  2. What are the potential risks and benefits of a restrictive fluid management strategy during pericardiectomy?
  3. How will a restrictive fluid management strategy impact my recovery and post-surgery outcomes?
  4. Are there any alternative approaches to fluid management during pericardiectomy that I should consider?
  5. How will my overall health and medical history affect the decision on fluid management during surgery?
  6. What specific post-surgery complications should I be aware of, and how can they be managed?
  7. Will I need any additional follow-up care or monitoring after the surgery, particularly related to fluid management?
  8. How will a restrictive fluid management strategy during pericardiectomy impact my length of stay in the hospital and overall recovery time?
  9. What are the long-term implications of fluid management during pericardiectomy for my heart health and overall well-being?
  10. Are there any lifestyle changes or precautions I should take following pericardiectomy to support a successful recovery?

Reference

Authors: Fang L, Zheng H, Yu W, Chen G, Zhong F. Journal: Front Surg. 2021 Aug 4;8:673466. doi: 10.3389/fsurg.2021.673466. eCollection 2021. PMID: 34422891