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1 case of coronary artery bypass surgery in the care of adult Kawasaki disease


Degree of 24h accurate records of intake and output and hourly intake and output, pericardial mediastinal drainage; closely observe the changes in consciousness, pupil size L larvae, peripheral temperature, limb activity, whichever is greater saphenous vein and the physical state of the blood supply detailed records. According to the value added measure blood volume, and adjust the use of vasoactive drugs in order to ensure perfusion of vital organs,[link widoczny dla zalogowanych], blood vessels and prevent bleeding or cracking at the bridge closure and reduce the incidence of stroke. 2.2 Respiratory function monitoring and care 2.2.1 Care during ventilator after endotracheal intubation with ventilator-assisted breathing then, breathing mode SIMV + PS, breathing 10 times / min, oxygen concentration 6O. PEEP 6C1TIHO. Tidal volume of 600ml. Breathing machine in the application,[link widoczny dla zalogowanych], must always regularly check the work of breathing machine index, patency and placement of pipe to prevent the take over the loss,[link widoczny dla zalogowanych], displacement or confrontation breathing. Close observation of patients without symptoms of hypoxia. Promptly withered section. Snapped into custody immediately after the gas analysis Author: 100730 Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing Union Medical College Hospital cardiac surgery Author: Du Jing, female. Born in 1979, undergraduate, Nurse. Teachers. Venipuncture from the center with a micro-pump supplies, so that to maintain serum potassium in the normal range. 2.4 Measurement of body temperature immediately after the body temperature monitoring, 72h body temperature within the close observation of changes in temperature above 38 ℃, when the ice pack to the physical cooling. 2.5 Monitoring of neurological function before anesthesia is not clear observation of bilateral pupil larvae L per hour of light reflection, conscious observation of physical activities and time conscious level. After removal of tracheal intubation through the patient to determine whether there is a language had signs of brain damage and make the appropriate treatment. 2.6 Postoperative anticoagulant therapy 2 times a day care prothrombin time (PT). L of the first postoperative day intravenous infusion of heparin anticoagulation. 3 days after stopping heparin infusion of 40mg injected race into grams per 1 l2 hours. This process occurs without symptoms of bleeding and embolism. 2.7 psychological care due to surgical trauma, postoperative pain and discomfort. We were in time to comfort, to give emotional support, eliminating the fear of patients. To actively cooperate with the treatment and care, successful rehabilitation. CABG is the treatment of Kawasaki disease coronary artery aneurysms and an important means of coronary artery stenosis]. CABG close monitoring of early postoperative cardiovascular function, good breath management, water and electrolyte balance in the maintenance of anticoagulation in patients with early treatment and attention to feelings and needs. Is to promote the key to successful rehabilitation of patients.
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