Background/IntroductionThe 2014 ESC/EACTS Guidelines on myocardial revascularization, define the SYNTAX Score, as a risk stratification model for the planning the type of treatment. The SYNTAX score was developed to grade the anatomical complexity of coronary lesions in patients with left main or three-vessel disease.
Objective To show if blood salvage is indicated in all patients submitted to cardiovascular
surgery with cardiopulmonary bypass. Methods We studied 77 consecutive patients submitted to cardiac surgery with use of blood
salvage and cardiopulmonary bypass from November 2010 to June 2012. The sample was
divided in three groups, depending on the time of cardiopulmonary bypass. In group
A, the time of cardiopulmonary bypass was smaller than 45, in group B from 45 to
90 and in group C greater than 90 minutes. We analyzed the volume of red cells
recovered and infused, the pre, intra and post-operative hemoglobin, the number of
packed red cells units which were transfused and hematocrit and hemoglobin blood
infused. Results The average group age was 60.44±12.09 years old, of whom 71.43% were males. The
group A was formed by 5.19% of the patients, B by 81.82% and C by 12.99%. The
volume of erythrocytes recovered and infused was respectively 1,360.50±511.37 ml
and 339.75±87.71 ml in group A, 1,436.63±516.06 ml and 518.83±183.0 ml in B and
2,137.00±925.04 ml and 526.20±227.15 ml in C. About packed red cells transfusions,
in group A 1,00±2,00 packed red cells were transfused, in B 1.27±1.85 packed red
cells and in C 2.56±2.01 packed red cells. The infused blood had a hematocrit of
50.97±12.06% and hemoglobin of 19.57±8.35 g/dl. Conclusion That blood salvage can be used in patients submitted to cardiovascular surgery
with cardiopulmonary bypass. However, it is only cost-effective in surgeries in
which the time of cardiopulmonary bypass is greater than 45 minutes.
A COVID-19 é causada por um betacoronavírus denominado SARS-CoV-2. O quadro clínico consiste em sinais e sintomas inespecíficos como febre, tosse seca, dispneia, mialgia, fadiga, cefaleia, anosmia e sintomas gastrointestinais. A recomendação de manejo invasivo de vias aéreas em pacientes com COVID-19 é por intubação orotraqueal de sequência rápida. Como esse e outros procedimentos anestesiológicos são geradores de aerossóis, é fundamental a proteção dos profissionais de saúde com Equipamentos de Proteção Individual (EPIs). Dessa forma, este estudo buscou avaliar a utilização de EPIs e também o conhecimento de médicos anestesiologistas no manejo de pacientes com COVID-19. Dos 53 profissionais entrevistados, 13 (24,5%) relataram que em pelo menos um procedimento não tiveram acesso aos EPIs necessários para sua segurança. Esse é possivelmente um dos fatores relacionados a elevada prevalência de adoecimento por COVID-19 na amostra de profissionais participantes do estudo (30,2%). Além disso, 28,3% dos participantes da pesquisa calcularam incorretamente o volume corrente de uma paciente fictícia. Assim, conclui-se que as condutas realizadas por esses profissionais são parcialmente adequadas ao manejo perioperatório de pacientes com COVID-19 de acordo com as literaturas consultadas. Portanto, são essenciais medidas de educação continuada para ampliar a assertividade dos médicos nas condutas realizadas. Ademais, as instituições de saúde devem prover EPIs necessários aos profissionais de saúde para reduzir a chance de infecção destes trabalhadores.
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