Objective: To present the complications that prolong the stay in the Intensive Care Unit (ICU) of the patients undergoing cardiac surgery.Methods: We retrospectively analyzed records of 85 patients undergoing cardiac surgery during the period of March to May 2009, at the Santa Casa de Misericordia de Juiz de Fora (MG), and, of these patients we studied 14 (16.47%) who stayed for more than five days in ICU. Amongst the 85 patients, there were three deaths, being two patients operated on an emergency basis, which increases morbidity, and one patient who remained in the hospital and under mechanical ventilation (MV) for 21 days.Results: The study showed that complications that increased the length of stay in ICU were respiratory and metabolic disorders, according to the literature.
Conclusion:The complications that increase length of stay in ICU are related to respiratory function, chronic obstructive pulmonary disease, smoking, lung congestion, prolonged switch-off from MV, diabetes, infections, kidney failure, stroke and hemodynamic instability.
167LAIZO, A ET AL -Complications that increase the time of Hospitalization at ICU of patients submitted to cardiac surgery Bras Cir Cardiovasc 2010; 25(2): 166-171
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Objective: To demonstrate the efficacy and safety of a multimodal stratified approach for prevention of thromboembolism in patients undergoing primary total hip arthroplasty. Method: A longitudinal retrospective clinical study of a cohort of 341 individuals undergoing total hip arthroplasty between March 2008 and July 2016. Of these, 242 patients met the criteria for inclusion in the study. Individuals with a history of deep vein thrombosis or pulmonary thromboembolism, thrombophilia, hypercoagulation conditions, and chronic users of anticoagulants before surgery received enoxaparin at a dose of 40 mg/day for 21 days. For the other group, acetylsalicylic acid was prescribed at a dose of 200 mg/day for 30 days. All patients had surgical risk assessed by the American Anesthesiology Association classified as I or II, and underwent regional anesthesia, effective hydration, the same protocol of early postoperative rehabilitation, and the use of compression stockings. Drug cost analysis was performed based on the Brasíndice. To date, there are no publications in PubMed and Scielo on this subject regarding the Brazilian population. Results: The need for blood transfusion in the enoxaparin group was higher and the overall complication and hemorrhagic rates were also significantly higher (p < 0.010) in this group. Aspirin prescription costs 39 times less than enoxaparin. Conclusion: In patients without predisposing factors to thromboembolism and undergoing primary total hip arthroplasty, the multimodal approach with acetylsalicylic acid seems to be effective, with low cost and a low rate of complications.
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