Changes in Liver Enzymes in the Patients Undergoing Open Cardiac Surgery and Related Factors

One of the most important gastrointestinal complications following cardiac surgery is hepatic dysfunction. This prospective study was evaluated the incidence and significance of liver dysfunction after open cardiac surgery. This study was conducted on 150 patients who were candidates for heart surgery. Liver tests including bilirubin (total and direct), alkaline phosphatase, AST, ALT were measured before the operation and on the first, third, and seventh postoperative days. Out of 150 patients, 80 were men (53.3) and 70 were women (46.7) with mean age of 62 +/- 12.5. Level of AST, ALT and bilirubin total has increased significantly after surgery (P<0.05). There were significant relationship between AST, ALT and alkaline phosphatase on first day after surgery and hypothermia less than 32 degrees C (P<0.05), blood transfusion more than 6 units (P<0.05), intraoperative hypotension (P <0.001), duration of the pump over 100 minutes (P < 0.001) and smoking (P<0.05). There was significant difference between two groups in length of ICU stay (7.14 +/- 9.17 days in patients with liver enzyme changes VS. 4.11 +/- 2.17 days in patients without liver enzyme changes, p-value<0. 05). Patients with changes in liver enzyme had a longer hospital stay (25.2 +/- 6.48 in patients with liver enzyme changes VS. 9.23 +/- 5.3 in patients without liver enzyme changes, p-value<0. 05). Four deaths occurred among patients with changes in liver enzyme level but there was no death in patients without changes in liver enzyme levels that this difference in mortality rate was statistically significant (<0.005). The results of this study showed that there is a significant relationship between and changes in liver enzymes and hypotension during the, hypothermia, the pump duration, blood transfusion, and the type of the pump

Effect of a family-centered clinical intervention on the anxiety of family members of the patients hospitalized in critical care units

Background and Objective: Hospitalization of patients in the intensive care units frequently results in anxiety of the family members. This study was performed to investigate the effect of a family-centered clinical intervention on the anxiety of family members of the patients hospitalized in intensive care units. Methods: In this clinical trail study, eighty family members of the patients hospitalized in the intensive care units were randomly divided into interventional and control groups, respectively. In the interventional group, the family members were allowed to be present at the bedside from the second till the sixth day.The participant's level of anxiety was assessed in the second and the sixth day of patient's hospitalization using hospital anxiety and depression scale. Oral information about the equipment and the regulations and, a daily information card consisting of treatment and care activities, vital signs and patient's level of consciousness was delivered to the participants and their questions were answered. Results: In the the sixth day, there was a significant difference between the mean anxiety scores in the intervention (11±3.22) and control group (7.05±3.44) (P<0.05). Also, the frequncey of anxiety in the interventional group (56%) was significantly higher than the control group with 15% (P<0.05). The odds ratio for anxiety in sons/daughters was lower than other family members in the sixth day (P<0.05). Conclusion: Providing information, presence at the bedside and participation in the care of their patient increase the anxiety of family members in the first week of patient hospitalization in the intensive care unit