Incidence of Orthostatic Hypotension during Early Postoperative Mobilization in Cardiac Surgery Patients

Yıl 2024, Cilt: 6 Sayı: 3, 491 - 503, 25.12.2024

Belma Ay , Hülya Bulut , Murat Kurtoğlu

Öz

This study aimed to determine the incidence of orthostatic hypotension and orthostatic intolerance during early mobilization in patients who underwent coronary artery bypass graft surgery. The study was conducted as single group pre-experimental study. Patients who underwent coronary artery bypass graft surgery (n=108) in a private hospital and a university hospital in Ankara were included in the sample. Data were collected between May 2018 and February 2019. The data were collected using a Patient Diagnostic Form and Patient Mobilization Follow-Up Form developed by the researcher. Patients were mobilized according to the mobilization program developed by the researchers. The study is reported according to Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) guidelines. The sample consisted of 108 patients (72.2% male, mean age 64.67 ± 9.40 years). Postoperative mobilization was 19.23 ± 3.08 hours. According to preoperative data, 52 participants (48.1%) had orthostatic hypotension, and 47 participants (43.5%) had orthostatic intolerance. Participants often presented signs of intolerance (26.9%) in the second mobilization phase. There was no significant difference in the incidence of orthostatic intolerance between participants with and without orthostatic hypotension (p = 0.269). The results indicate that orthostatic hypotension and orthostatic intolerance are prevalent in patients after coronary artery bypass graft surgery. Healthcare professionals should diagnose orthostatic hypotension early with accurate hemodynamic measurements and monitoring of symptoms.

Anahtar Kelimeler

Cardiac Surgery, Early Mobilization, Intensive Care Unit, Orthostatic Hypotension

Kardiyak Cerrahi Uygulanan Hastalarda Erken Mobilizasyon Sırasında Ortostatik Hipotansiyon Görülme Sıklığı

Öz

Bu çalışmanın amacı, koroner arter bypass greft ameliyatı geçiren hastalarda erken mobilizasyon sırasında ortostatik hipotansiyon ve ortostatik intolerans görülme sıklığını belirlemektir. Araştırma tek gruplu deney öncesi araştırma tasarımı olarak yürütülmüştür. Çalışmanın örneklemini Ankara'da bir özel hastane ve bir üniversite hastanesinde koroner arter bypass greft ameliyatı geçiren hastalar (n=108) oluşturmaktadır. Veriler Mayıs 2018 ile Şubat 2019 tarihleri arasında toplanmıştır. Veriler araştırmacı tarafından geliştirilen Hasta Tanı Formu ve Hasta Mobilizasyon Takip Formu kullanılarak toplanmıştır. Hastalar araştırmacıların geliştirdiği mobilizasyon programına göre ameliyat sonrası mobilize edilmiştir. Çalışma Rastgele Olmayan Tasarımlarla Değerlendirmelerin Şeffaf Raporlanması kurallarına göre raporlanmıştır. Örneklem 108 hastadan (%72.2 erkek, ortalama yaş 64.67 ± 9.40 yıl) oluşmaktadır. Hastalar ameliyat sonrası 19.23 ± 3.08 saatte mobilize edilmiştir. Katılımcıların ameliyat öncesi ve mobilizasyon sırasındaki hemodinamik verileri karşılaştırıldığında 52 katılımcıda (%48.1) ortostatik hipotansiyon, 47 katılımcıda (%43.5) ortostatik intolerans saptanmıştır. Katılımcılarda sıklıkla mobilizasyonun ikinci aşamasında (%26.9) ortostatik intolerans belirtileri görülmüştür. Ortostatik hipotansiyonu olan ve olmayan katılımcılar arasında ortostatik intolerans insidansı açısından anlamlı bir fark saptanmamıştır (p = 0.269). Sonuç olarak, koroner arter bypass greft ameliyatı sonrası hastalarda ortostatik hipotansiyon ve ortostatik intolerans yaygın olarak görülmektedir. Sağlık çalışanları doğru hemodinamik ölçümler ve semptomların takibi ile ortostatik hipotansiyonu erken tanılamalıdır.

Anahtar Kelimeler

Kardiyak Cerrahi, Erken Ambülasyon, Yoğun Bakım Üniteleri, Ortostatik Hipotansiyon

Kaynakça

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