The Importance of Detecting Hypoxic Ischemic Events During Open Heart Surgery

Open Heart Surgery is an extremely serious operation, including risks such as bleeding, infection, kidney failure, myocardial infarction and neurological complications. During cardiac surgery there is also the potential for reduced oxygen perfusion to the brain along with falling blood pressure as a result of reduced heart function, reducing cerebral perfusion and oxygen supply. This can result in brain damage and is known as a Hypoxic Ischemic Event (HIE.)

If prolonged, a HIE can have a significant effect on the body. In the liver, they can lead to acute ischaemic hepatitis, whereby the liver becomes dysfunctional. HIE can also lead to kidney failure as well as permanent heart muscle damage. In the brain, brain damage can occur which can lead to stroke or cognitive dysfunction, cerebellar disorders, psychiatric issues, cranial nerve defects and memory loss.

The best way of ensuring that the above does not occur is to prevent a HIE by maintain adequate oxygenation and blood pressure both before and after surgery. However, if HIE does occur, as the potential risks are increased when prolonged, early detection is key so as to minimise the impact. Therefore, if any of the above factors are shown, these should be investigated as soon as possible through MRI imaging so as to minimise the impact of the HIE upon the body and brain.

Important Note

This article is intended to raise awareness to clinical risk issues in an effort to reduce incidence recurrence and improve patient safety. This is not intended to be relied upon as advice. Facts have been altered to ensure this case is non-identifiable, albeit clinical learning points remain applicable.