رسالة جامعية
ERAS for Cardiac Surgery: Development of a Clinical Practice Guideline for Antifibrinolytic Administration in Cardiac Surgery
| العنوان: | ERAS for Cardiac Surgery: Development of a Clinical Practice Guideline for Antifibrinolytic Administration in Cardiac Surgery |
|---|---|
| المؤلفون: | Foltz, Christopher Thomas |
| بيانات النشر: | Otterbein University / OhioLINK, 2022. |
| سنة النشر: | 2022 |
| المجموعة: | Ohiolink ETDs |
| Original Material: | http://rave.ohiolink.edu/etdc/view?acc_num=otbn1650100720651036Test |
| مصطلحات موضوعية: | Health, Health Sciences, Nursing, Surgery, Medicine, Tranexamic Acid, TXA, Antifibrinolytic, Blood conservation, Epsilon Aminocaproic Acid, Amicar, Cardiac Surgery, ERAS |
| الوصف: | Enhanced Recovery After Surgery (ERAS) guidelines are multimodal perioperative carepathways based on evidence-based practice to promote faster recovery after surgical procedures.For cardiac surgery ERAS, one intervention that is strongly recommended based on high levelsof evidence is the use of antifibrinolytic medications, such as Tranexamic acid (TXA) andepsilon aminocaproic acid (EACA) which are synthetic antifibrinolytics and analogs of lysine,both known for exerting procoagulant effects by competitively inhibiting activation ofplasminogen to plasmin. Antifibrinolytic medications have been shown to decrease blood loss aswell as the need for blood transfusions and reoperation.There is strong evidence from the literature for best practices and well-establishedinternational standard ERAS guidelines for cardiac surgery. Reports from key stakeholders inthe pharmacy and anesthesia departments at the project site revealed that the routine use ofantifibrinolytic administration is varied within the cardiac surgical setting. The project teamconducted a chart audit that revealed over a three-month period, only 61% (n= 22/36) of cardiacsurgery patients received an antifibrinolytic. Upon further investigation of the patients that didnot receive an antifibrinolytic, 50% (7/14) of those patients required on pump cardiac surgeryand should have received an antifibrinolytic. A review of the anesthesia records also revealedvariations in dosing among the 22 patients that did receive an antifibrinolytic. 36% (8/22) ofthese patients received 10g of EACA, 59% (13/22) received 20g of EACA, and 4% (1/22)received 10mg of TXA. As a result of the chart audit findings, a clinical practice guideline wasdeveloped for TXA and EACA using the Clinical Guidance Recommendation template at theinstitution. The guideline was shared with the Surgery/Anesthesia CPIT Committee for possiblefuture implementation.Co-Author: Lawson, Katonya |
| Original Identifier: | oai:etd.ohiolink.edu:otbn1650100720651036 |
| نوع الوثيقة: | text |
| اللغة: | English |
| الإتاحة: | http://rave.ohiolink.edu/etdc/view?acc_num=otbn1650100720651036Test |
| حقوق: | unrestricted This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws. |
| رقم الانضمام: | edsndl.OhioLink.oai.etd.ohiolink.edu.otbn1650100720651036 |
| قاعدة البيانات: | Networked Digital Library of Theses & Dissertations |
| الوصف غير متاح. |