Cabg

A study to explore the effect of health education on recovery following patients after CABG Surgery. Background: Coronary Artery Disease (CAD) is one of the major public health problems in developing countries. CAD in Sudan is showing an increasing trend. Coronary artery bypass graft surgery improves the quality of life of CAD patients and helps them to return to normal life, and the early Recovery period presents a number of challenges for patients, corers, and Nurse. Objectives to explore the effects of an educational program on patient knowledge and self-care ability of the patients following coronary artery bypass surgery Method: This was A Quasi, interventional and hospital-based study, including pre-, post, and follows up tests with a control group, conducted for the period: September 2014 to June 2019. Patients were recruited consecutively to the cases and control using convenience sampling. It consists of 76 patients, 41 as cases and 35 in control. Who had undergone CABG surgery in Khartoum State. A Questionnaire and checklist were used to monitor the effect of an educational program. Result: The results showed marked improvement in knowledge and performance between pre and post-test for the study group, p = (0.001) in the health status of cases in comparison to the control group. The indices were observed to be higher for patients who received a nursing educational program throughout the study period P= (0.002). Conclusion: Our study revealed marked improvement in the health status of the cases by comparison to the control group.

Background:
Severe beeding which requiring massive blood transfusion after emergent beating heart surgery is shown to be 1–3%. Therefore, complications and side effects of transfusion can be seen. The aim of this study was to investigate the effectiveness of Ankaferd blood clotter (ABC) as a new topical herbal blood clotter to decrease mediastinal bleeding in emergent beating heart CABG patients who medicated with clopidogrel and acetyl salisilic acite (ASA) prior to CABG surgery.

Materials and Methods: 25 CABG patients received a high dose clopidogrel (600 mgr) and 300 mgr ASA have been included into the study (ABC group). 25 patients have also been included into the study for comparison (placebo group, PG). After the administration of protamine sulphate, a 10 ml of ABC solution has been sprayed to the surgical area including mediastinum and epicardial sac. We compared mediastinal drenaige, reoperation due to tamponade, and required blood and blood products in both groups.

Results:
The mean amount of bleeding after operation was 230 ml in ABC group, and 490 ml in CG (P=0.001). In ICU, bleeding in ABC group and CG was 410ml and 680ml, respectively (P=0.0022). The mean total bleeding from mediastinum was 530±280 mL and 990±440 mL In ABC and CG group, respectively (P=0.001). The amount of autotransfusion was as follows: 175 mL in ABC group, and 290 mL in CG (P=0.002). No patient needed the surgical revision in ABC group, but four patients (16%) from CG group because of cardiac tamponade. Seventeen patients from CG required blood transfusion due to low hematocrite level postoperatively. In CG, the mean hematocrite level was 17±2,3. Transfusion of fresh frozen plasma and platelets in ABC group and CG were as follows: 0.2 and 0 in ABC group, and 0.3and 0.4 in CG.

Conclusion:
Our study showed that the local use of 10 mL ABC reduces bleeding significantly. Therefore, transfusion requirements of PRBC, platelets, and total blood units in patients on clopidogrel and ASA undergoing emergent beating heart CABG. To provide cardiac tamponade because of excessive mediastinal bleeding and requirement of blood transfusion after emergent CABG patients who previously administered clopidogrel and ASA, we propose local use of ABC solution as a potent coagulant agent.