Cirurgia de revascularização miocárdica sem circulação extracorpórea: uma técnica em busca de evidências

Blacher, Celso; Ribeiro, Jorge Pinto

doi:10.1590/s0066-782x2003000600011

Cited by 2 publications

(5 citation statements)

References 40 publications

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“…We found studies that described their groups of elderly with age ≥ 65 years-old [12], ≥ 70 yearsold [13][14][15][16][17], ≥ 75 years-old [6,21], ≥ 80 years-old [22] and ≥ 85 years-old [23]. Therefore we will suggest that more studies to be made in order to can to conclude in which age the risks factors of this surgery appear enlarged, whether preoperative, intraoperative or postoperative outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Impact of coronary artery bypass grafting in elderly patients

Aikawa¹,

Cintra²,

Leite³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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Objective: To analyze the results of isolated on-pump coronary artery bypass graft surgery (CABG) in patients ≥ 65 years-old.Methods: Patients undergoing isolated on-pump CABG from December 1 st 2010 to July 31 th 2012 were divided in two groups: GE (elderly ≥ 65 years-old, n=103) and GA (adults < 65 years-old, n=150). Preoperative data, intraoperative (as cardiopulmonar bypass time, aortic clamping time, time length of stay in mechanical ventilation -MV -and number of grafts), and postoperative variable (as morbidity, mortality and time length of stay in hospital) were analyzed during hospitalization.Results: In GE, the morbidity rate was greater than in GA (30% vs. 14%, P=0.004), but there was no difference in the mortality rate (5.8% vs. 2.0%, P=0.165). In GA, there was higher prevalence DM (39.6% vs. 27%, P=0.043) and smoking (32.2% versus 19.8%, P=0.042); and in GE, higher prevalence of stroke (17% vs. 6.7%, P=0.013). There was no difference between the groups regarding intraoperative variables. After multivariate analysis, age ≥ 65-year-old was associated with greater morbidity, but it was not independent predictive factor for in-hospital mortality. Considering in-hospital mortality, stay in ward time length (P=0.006), cardiac (P=0.011) and respiratory complications (P=0.026) were independent predictive factors.Conclusion: This study suggests that patients ≥ 65-yearold were at increased risk of postoperative complications when submitted to isolated on-pump CABG in comparison to patients < 65-year-old, but not under increased risk of death.

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Section: Discussionmentioning

confidence: 99%

“…Thus, the indication of CABG for elderly patients is increasing because it provides better survival and quality of life [8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Impact of coronary artery bypass grafting in elderly patients

Aikawa¹,

Cintra²,

Leite³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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“…The contact with non-endothelial surfaces and filters present in the CPB circuit increases the mechanical stress suffered by the RBCs. Thus, many of them undergo disruption [23].…”

Section: Introductionmentioning

confidence: 99%

“…23 shows the averages for each radial position obtained with all radial profile of cell thickness data from RBCs from experiment 1.Table 3.9 shows the results of the Student's t-test for the comparison between samples.…”

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confidence: 99%

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Investigation of the influence of red and infrared illumination on mechanical properties of cells: Photobiomodulation

Magalhães¹

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The photobiomodulation therapy (PBMT) has many demonstrated applications in the health area including anti-inflammatory and wound healing effects. The main objective of this work is to verify if the PBMT causes measurable changes in the mechanical properties of cells, specifically in red blood cells, epithelial cells and fibroblasts. In addition, to contribute to the knowledge of the action mechanisms of the PBMT, this study intends to support applications of the PBMT during invasive procedures, such as the direct photo-treatment of the blood in surgical procedures with cardiopulmonary bypass, regarding security of the cellular integrity. For this analysis, three experimental techniques were used: optical magnetic twisting cytometry (OMTC), defocusing microscopy and confocal laser-scanning microscopy. Human bronchial epithelial cells were evaluated with OMTC. The epithelial cell culture was either photo-treated or not, with red laser (λ=660 nm), and fixed power and time (power density of 153 mW/cm 2 , time 300 s). It was not possible to observe significant differences between photo-treated and control epithelial cells, for the hysteresivity (ratio between the cell loss and elastic shear moduli). The defocusing microscopy, similar to a phase contrast microscopy, was used to study human red blood cells from fresh blood. The red blood cells were either photo-treated or not, with red laser (λ=660 nm), and different powers and times (power densities from 0 to 510 mW/cm 2 , times from 0 to 180 s). Some morphological and mechanical characteristics of individual red blood cells were evaluated, such as volume, radial profile of cell thickness, lateral and vertical membrane fluctuations, for the photo-treated and control red blood cells. It was not possible to detect differences between the two groups, for any of the parameters analyzed. For both techniques, the absence of detectable differences might be due to several factors, such as the nonaction of the PBMT, with the parameters used, in the epithelial cells and red blood cells or to the small sensitivity of each technique. Confocal laser-scanning microscopy was used to evaluate the actin filaments of mouse fibroblasts. The fibroblast cell culture was either photo-treated or not, with red (λ=625 nm) or infrared (λ=808 nm) light and fixed power and time (power density from 113 to 158 mW/cm 2 , time 300 s). The nucleus and cell areas increased slightly when comparing photo-treated and control cells. On the other hand, the total actin, total actin density and the number of filaments decreased. These changes were detected for a short time after treatment, however, 10 after 24 h they are not anymore detectable. The total branch length does not seem to suffer any modifications. In summary, with the data acquired with the three techniques, it was found that the PBMT, in the red range, with the parameters used, could not cause noticeable changes in red blood cells and epithelial cells, in vitro. On the other hand, the PBMT in the red and near-infrared range, with the power and ...

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Cirurgia de revascularização miocárdica sem circulação extracorpórea: uma técnica em busca de evidências

Cited by 2 publications

References 40 publications

Impact of coronary artery bypass grafting in elderly patients

Impact of coronary artery bypass grafting in elderly patients

Investigation of the influence of red and infrared illumination on mechanical properties of cells: Photobiomodulation

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