Post craniotomy and electrocardiographic monitoring

Authors

  • Hendy Lesmana Department of Critical Care and Emergency Nursing, University of Borneo Tarakan, Tarakan City, Nort of Kalimantan, Indonesia
  • Ahmat Pujianto Department of Critical Care and Emergency Nursing, University of Borneo Tarakan, Tarakan City, Nort of Kalimantan, Indonesia
  • Bayu Purnomo Nursing of Intensive Care Unit, Regional Public Hospital of Tarakan, Tarakan City, Nort of Kalimantan, Indonesia

DOI:

https://doi.org/10.18203/2320-6012.ijrms20215033

Keywords:

Acid-base balance disorders, Electrocardiographic monitoring, Electrolyte balance disorders, Post craniotomy

Abstract

Background: Post craniotomy management mainly emphasizes monitoring complications that occur. Close supervision and monitoring are needed in post craniotomy patients, especially in the first 48 hours so that the patient is placed in the intensive care unit (ICU). Various studies have identified various complications that arise from mild complications to severe complications, namely the death of patients after craniotomy, so that hemodynamic monitoring tool are needed. Electrocardiography is one of the hemodynamic monitoring tools in the intensive care room which is very useful in monitoring heart rhythm abnormalities in post-craniotomy patients.

Methods: This descriptive study was conducted on 30 respondents post craniotomy and were treated in the Intensive Care Unit (ICU) for 1-3 days of treatment. An electrocardiographic monitoring analysis was performed on 30 respondents, then confirmed by examination of blood electrolytes and blood gas analysis.

Results: In this study 90% of respondents experienced electrocardiographic rhythm abnormalities, 50% sinus arrhythmia, 33.3% sinus tachycardia, 6.7% sinus bardycardia. The results of electrolyte examination 18 respondents experienced electrolyte balance disorders where 4 respondents experienced hyponatremia, 7 respondents experienced hypernatremia+hyperchloremia, 1 respondent experienced hyponatremia+hypochloremia, 5 respondents experienced hyperchloremia and 1 respondent experienced hypokalemia. There are 7 respondents experiencing acid-base balance disorders.

Conclusions: in this study showed that most of the patients after craniotomy had heart rhythm abnormalities. The most common arrhythmia is sinus arrhythmia. The pathological conditions that accompany these rhythm disturbances are mostly caused by electrolyte balance disorders, acid-base balance disorders or a combination of the two disorders.

Author Biography

Hendy Lesmana, Department of Critical Care and Emergency Nursing, University of Borneo Tarakan, Tarakan City, Nort of Kalimantan, Indonesia

Critical Care and Emergency Nursing

References

Satyanegara. Ilmu bedah saraf. 4th ed. Jakarta: Gramedia Pustaka Utama. 2013;1-508.

Garret M, Spetzler R. Craniotomy. In: Michael J. Aminoff, Daroff RB, editors. Encyclopedia of the Neurological Science. 2nd ed. San Diego: Elsevier Inc. 2014;896-7.

Jasa KZ, Jamal F, Hidayat I. Luaran Pasien Cedera Kepala Berat yang Dilakukan Operasi Kraniotomi Evakuasi Hematoma atau Kraniektomi Dekompresi di RSU Dr. Zainoel Abidin Banda Aceh. J Neuroanestesi Indones. 2014;3(1):8-14.

Tanriono C, Lalenoh DC, Laihad ML. Profil Pasien Pasca Kraniotomi di ICU RSUP Prof . Dr . R . D . Kandou. J EClinic. 2017;5(2):275-8.

Teguh PH. Angka Kematian Pasien Kraniotomi Di ICU Dan HCU RSUP dr. Kariadi. Universitas Diponegoro; 2012. Available at: http://eprints.undip.ac.id/37551/1/Hendra_Teguh_P_G2A008092_LAPORAN_KTI.pdf. Accessed on 20 May 2021.

Philip J. Pemantauan pasien kritis. 2nd ed. Jakarta: Erlangga. 2008;1-304.

Lonjaret L, Guyonnet M, Berard E, Vironneau M, Peres F, Sacrista S, et al. Postoperative complications after craniotomy for brain tumor surgery. Anaesth Crit Care Pain Med. 2017;36(4):213-8.

Li A, Azad TD, Veeravagu A, Bhatti I, Long C, Ratliff JK, et al. Cranioplasty Complications and Costs: A National Population-Level Analysis Using the MarketScan Longitudinal Database. World Neurosurg. 2017;102:209-20.

Finkelstein D, Nigaglioni A. Electrocardiographic alterations after neurosurgical procedures. Am Heart J. 1961;62(6):772-84.

Thaler MS. Satu-Satunya Buku EKG yang Anda Perlukan Edisi 2. 2nd ed. Jakarta: Hipokrates. 2000;1-362.

Yamamoto S, Masaki H, Kamata K, Nomura M, Ozaki M. A case of failed awake craniotomy due to progressive intraoperative hyponatremia. JA Clin Reports. 2018;4(40):1-4.

Hirota K, Hara T, Hosoi S, Sasaki Y, Hara Y, Adachi T. Two cases of hyperkalemia after administration of hypertonic mannitol during craniotomy. J Anesth. 2005;19(1):75-7.

Muriithi AK. The Effect Of Intraoperative Co-Administration Of Ringers Lactate Combined With 0.9% Normal Saline On Serum Electrolytes And Lactate In Patients Undergoing Elective Craniotomy. UNIVERSITY OF NAIROBI; 2018. Available at: http://erepository.uonbi.ac.ke/handle/11295/105209. Accessed on 20 May 2021.

Silbernagl S, Lang F. Teks & Atlas Berwarna Patofisiologi Edisi 3. EGC. Jakarta. 2018;1-406.

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Published

2021-12-28

How to Cite

Lesmana, H., Pujianto, A., & Purnomo, B. (2021). Post craniotomy and electrocardiographic monitoring. International Journal of Research in Medical Sciences, 10(1), 40–45. https://doi.org/10.18203/2320-6012.ijrms20215033

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Section

Original Research Articles