An Evaluation of Inotropic Use Post- Cardiac Surgery at the Kenyatta National Hospital

Abstract

Introduction: Cardiac Surgery in Kenya has evolved over the past few decades amid a myriad of challenges. One of these challenges appears to be low cardiac output syndrome as well as the minimum availability of published data. This study aims to evaluate the pattern of inotropic use post cardiac surgery in the critical phase. Materials and Methods: The study is a retrospective cross-sectional design. A data collection sheet was used to retrospectively collect data post cardiac surgery between 2013 and 2016 in Kenyatta National Hospital. The pattern of inotropic use vis-a-vis various pre-operative and intraoperative factors was then compared to the duration and number of inotropes used while the patient was in the critical care unit. This data was analysed using Microsoft excel and SPSS v20 Results: 109 patient files were perused. The study showed a marked variance in the pattern of inotropic use post cardiac surgery in KNH with adrenaline use singularly being the most common (78%). There was no algorithm in systematic introduction of inotropes post cardiac surgery. Risk factors were correlated via t-tests to length of ICU stay with no significant findings which indicated that patients are kept unnecessarily longer in ICU. However, long cardiopulmonary bypass time was found to have a positive correlation to use of high dose inotropes as well as increased morbidity and mortality.