Objective. To describe the prevalence of burnout syndrome among intensive care physicians in Salvador, Brazil, and analyze it for associations with demographic data and aspects of their working conditions (psychological demands and control over tasks).MethOds. This was a cross-sectional study investigating associations between psychosocial aspects of work and professional burnout in a population of 297 intensive care physicians in Salvador. A selfadministered individual questionnaire was used to collect data on psychosocial features of work using the demand-control model (Job Content Questionnaire) and on the mental health of the physicians using the Maslach Burnout Inventory (MBI).Results. An elevated level of working hours overload and on-call work overload was observed. The prevalence of professional burnout was 7.4% and was more strongly associated with the psychological demands of work than with intensive care physician's control over that work. cOnclusiOns. Physicians doing highly demanding work (many demands and little control) suffered 10.2 times more burnout than those with undemanding work (few demands and a high degree of control).
AIMTo analyze whether fluid overload is an independent risk factor of adverse outcomes after liver transplantation (LT).METHODSOne hundred and twenty-one patients submitted to LT were retrospectively evaluated. Data regarding perioperative and postoperative variables previously associated with adverse outcomes after LT were reviewed. Cumulative fluid balance (FB) in the first 12 h and 4 d after surgery were compared with major adverse outcomes after LT.RESULTSMost of the patients were submitted to a liberal approach of fluid administration with a mean cumulative FB over 5 L and 10 L, respectively, in the first 12 h and 4 d after LT. Cumulative FB in 4 d was independently associated with occurrence of both AKI and requirement for renal replacement therapy (RRT) (OR = 2.3; 95%CI: 1.37-3.86, P = 0.02 and OR = 2.89; 95%CI: 1.52-5.49, P = 0.001 respectively). Other variables on multivariate analysis associated with AKI and RRT were, respectively, male sex and Acute Physiology and Chronic Health Disease Classification System (APACHE II) levels and sepsis or septic shock. Mortality was shown to be independently related to AST and APACHE II levels (OR = 2.35; 95%CI: 1.1-5.05, P = 0.02 and 2.63; 95%CI: 1.0-6.87, P = 0.04 respectively), probably reflecting the degree of graft dysfunction and severity of early postoperative course of LT. No effect of FB on mortality after LT was disclosed.CONCLUSIONCumulative positive FB over 4 d after LT is independently associated with the development of AKI and the requirement of RRT. Survival was not independently related to FB, but to surrogate markers of graft dysfunction and severity of postoperative course of LT.
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