Our Summary

This study looked at how opening the chest during surgery (sternotomy) affects two measurements used to determine if a patient needs more fluids: delta pulse pressure and delta down. The researchers found that opening the chest significantly changes the delta pulse pressure reading but not the delta down reading. This suggests that the delta down measurement could be more reliable when monitoring fluid levels during open chest surgery. However, more research is needed before this becomes standard practice.

FAQs

  1. What is the impact of sternotomy on the delta pulse pressure reading?
  2. Does opening the chest during surgery affect the delta down reading?
  3. Could the delta down measurement be a more reliable method for monitoring fluid levels during open chest surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about sternotomy is to follow post-operative care instructions carefully, including taking prescribed medications, attending follow-up appointments, and avoiding activities that could strain the chest area. It is important to allow the chest to heal properly to reduce the risk of complications and promote a successful recovery.

Suitable For

Patients who undergo open heart surgery, lung surgery, or other complex chest surgeries are typically recommended sternotomy. This procedure allows for better access to the chest cavity and organs, making it easier for surgeons to perform the necessary procedures.

Timeline

  • Before sternotomy:
  1. Patient undergoes pre-operative preparations, including medical history review and physical examination.
  2. Patient is placed under anesthesia and prepared for surgery.
  3. Surgeon makes an incision along the sternum to access the heart and other organs.
  4. Sternotomy is performed to open the chest and provide access to the surgical site.
  • After sternotomy:
  1. Patient is closely monitored in the intensive care unit (ICU) or post-anesthesia care unit (PACU) for any complications.
  2. Patient may experience pain, discomfort, and limited mobility due to the surgical incision and sternotomy.
  3. Patient undergoes a recovery process, which may include physical therapy and rehabilitation to regain strength and mobility.
  4. Follow-up appointments with healthcare providers are scheduled to monitor the patient’s progress and address any concerns or complications.

What to Ask Your Doctor

  1. What is a sternotomy and why is it necessary for my surgery?
  2. How will a sternotomy affect my recovery time?
  3. What are the potential risks and complications associated with a sternotomy?
  4. How will the sternotomy impact my ability to breathe and move after surgery?
  5. How will the sternotomy affect my pain levels post-surgery and what pain management options are available?
  6. How will the sternotomy impact my long-term health and well-being?
  7. How will the sternotomy affect my ability to participate in physical activities or exercise in the future?
  8. Are there any alternative surgical approaches that do not involve a sternotomy?
  9. How will the sternotomy impact the measurement of delta pulse pressure and delta down during surgery?
  10. What steps will be taken to monitor and manage my fluid levels during and after the surgery?

Reference

Authors: Deflandre E, Delande S, Cauvain J, Geradon P, Donneau AF, Lacroix S, Van Dyck M. Journal: J Cardiothorac Vasc Anesth. 2019 Aug;33(8):2201-2207. doi: 10.1053/j.jvca.2018.11.009. Epub 2018 Nov 14. PMID: 30581108