HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Robert L. McKowen George J. Magovern George A. Liebler John A. Burkholder Thomas D. Maher Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by McKowen, R. L. Articles by Maher, T. D. Search for Related Content PubMed PubMed Citation Articles by McKowen, R. L. Articles by Maher, T. D.

Ann Thorac Surg 1985;40:388-392
© 1985 The Society of Thoracic Surgeons

---

Articles

Infectious Complications and Cost-Effectiveness of Open Resuscitation in the Surgical Intensive Care Unit after Cardiac Surgery

From the Department of Surgery, Allegheny General Hospital, Pittsburgh, PA.

^* Address reprint requests to Dr. Magovern, Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA 15212

From July, 1982, to May, 1984, 2,412 patients underwent cardiac surgery. Open resuscitation through a midline sternotomy was performed in the surgical intensive care unit (SICU) 88 times in 64 patients one minute to 10 days after admission. There were 49 initial survivors; 31 patients had primary closure in the SICU (Group 1), and 18 patients had delayed closure (Group 2). In Group 1 there was 1 death. Wound infection developed in 2 of the 30 survivors—Escherichia coli in 1 and Staphylococcus epidermidis in 1. The latter required subsequent debridement. In Group 2 there were 8 survivors and no wound infections. Fifteen patients could not be resuscitated because of ventricular arrhythmia (13%), asystole (33%), cardiogenic shock (47%), and tamponade (7%). Only 2 of 38 patients, or 5%, experienced wound infections. This study demonstrates that open resuscitation in the SICU is a safe, rapid, and cost-effective procedure that will allow earlier intervention, diagnosis, and treatment. In no instance was death attributed to wound infection, and at our institution, this method resulted in cost savings of more than $1,000 per patient.

This article has been cited by other articles:

				J. Dunning, A. Fabbri, P. H. Kolh, A. Levine, U. Lockowandt, J. Mackay, A. J. Pavie, T. Strang, M. I. M. Versteegh, S. A. M. Nashef, et al. Guideline for resuscitation in cardiac arrest after cardiac surgery Eur J Cardiothorac Surg, July 1, 2009; 36(1): 3 - 28. [Abstract] [Full Text] [PDF]

				Z. Adam, S. Adam, R. L. Everngam, R. K. Oberteuffer, A. Levine, T. Strang, K. Gofton, and J. Dunning Resuscitation after cardiac surgery: results of an international survey Eur J Cardiothorac Surg, July 1, 2009; 36(1): 29 - 34. [Abstract] [Full Text] [PDF]

				E. Y. L. Yap, A. Levine, T. Strang, and J. Dunning Should additional antibiotics or an iodine washout be given to all patients who suffer an emergency re-sternotomy on the cardiothoracic intensive care unit? Interact CardioVasc Thorac Surg, June 1, 2008; 7(3): 464 - 469. [Abstract] [Full Text] [PDF]

				C. P. Charalambous, C. S. Zipitis, and D. J. Keenan Chest Reexploration in the Intensive Care Unit After Cardiac Surgery: A Safe Alternative to Returning to the Operating Theater Ann. Thorac. Surg., January 1, 2006; 81(1): 191 - 194. [Abstract] [Full Text] [PDF]

				N. Bouboulis, L. F. Rivas, J. Kuo, D. Dougenis, J. H. Dark, and M. P. Holden Packing the chest: A useful technique for intractable bleeding after open heart operation Ann. Thorac. Surg., April 1, 1994; 57(4): 856 - 860. [Abstract] [PDF]

				G. C. Kaiser, K. S. Naunheim, A. C. Fiore, H. H. Harris, L. R. McBride, D. G. Pennington, H. B. Barner, and V. L. Willman Reoperation in the intensive care unit Ann. Thorac. Surg., June 1, 1990; 49(6): 903 - 908. [Abstract] [PDF]