Alta dose de amiodarona em curto período reduz incidência de fibrilação atrial e flutter atrial no pós-operatório de cirurgia de revascularização miocárdica

Alcalde, Rafael; Guaragna, João Carlos Vieira da Costa; Bodanese, Luiz Carlos; Castro, Iran; Sussenbach, Eliana; Noer, Roberta; Goldani, Marco Antônio; Feier, Flávia Heinz; Petracco, João Batista

doi:10.1590/s0066-782x2006001600002

Cited by 8 publications

(6 citation statements)

References 15 publications

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“…Among the most common complications we found atrial fibrillation and flutter, pulmonary congestion and stroke [7,15,22]. Jaeger et al [24] showed that 14% of patients presented perioperative AMI.…”

Section: Discussionmentioning

confidence: 99%

“…Because of hemodynamic instability that can happen in the immediate postoperative period, the patient may need inotropic support (VAD) and must remain in the Intensive Care Unit (ICU) while there is need [15][16][17]. The controls of vital data, such as capillary blood glycemia and monitoring are performed on an hourly basis, which can also bring discomfort to the patient [2,[18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

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Complicações que aumentam o tempo de permanência na unidade de terapia intensiva na cirurgia cardíaca

Laizo¹,

Delgado²,

Rocha³

2010

Rev Bras Cir Cardiovasc

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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 Rev

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Complicações que aumentam o tempo de permanência na unidade de terapia intensiva na cirurgia cardíaca

Laizo¹,

Delgado²,

Rocha³

2010

Rev Bras Cir Cardiovasc

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“…Cardiac surgery is a complex procedure that alters several mechanisms required for homeostasis, leading the patient to a critical condition. To ensure adequate recovery, intensive care are needed during post-operative period, including vital signs monitoring and mechanical ventilation (MV) [ 1 , 2 ] .…”

Section: Introductionmentioning

confidence: 99%

Application of mechanical ventilation weaning predictors after elective cardiac surgery

Silva¹,

Borges²,

Costa³

et al. 2015

Revista Brasileira De Cirurgia Cardiovascular

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OBJECTIVETo test several weaning predictors as determinants of successful extubation after elective cardiac surgery.METHODSThe study was conducted at a tertiary hospital with 100 adult patients undergoing elective cardiac surgery from September to December 2014. We recorded demographic, clinical and surgical data, plus the following predictive indexes: static compliance (Cstat), tidal volume (Vt), respiratory rate (f), f/ Vt ratio, arterial partial oxygen pressure to fraction of inspired oxygen ratio (PaO2/FiO2), and the integrative weaning index (IWI). Extubation was considered successful when there was no need for reintubation within 48 hours. Sensitivity (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR-) were used to evaluate each index.RESULTSThe majority of the patients were male (60%), with mean age of 55.4±14.9 years and low risk of death (62%), according to InsCor. All of the patients were successfully extubated. Tobin Index presented the highest SE (0.99) and LR+ (0.99), followed by IWI (SE=0.98; LR+ =0.98). Other scores, such as SP, NPV and LR-were nullified due to lack of extubation failure.CONCLUSIONAll of the weaning predictors tested in this sample of patients submitted to elective cardiac surgery showed high sensitivity, highlighting f/Vt and IWI.

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“…Several clinical trials have evaluated the effectiveness of pharmacological interventions in reducing the incidence of this arrhythmia [18][19][20][21][22] . However, these trials are generally not much statistically significant when the effects of these treatments on shorter hospital stay or on the occurrence of stroke are estimated to estimate.…”

Section: Discussionmentioning

confidence: 99%

“…It can be indicated to treat ventricular arrhythmias, supraventricular paroxysmal tachycardia, fibrillation and atrial flutter. Moreover, it has also shown to be safe and effectivve in the prevention of atrial fibrillation in cardiac surgery postoperative period 18 .…”

Section: Introductionmentioning

confidence: 99%

Prevenção de fibrilação atrial com amiodarona em moderada dosagem no pós-operatório de cirurgia cardíaca é segura e eficaz em pacientes de alto risco para desenvolver essa arritmia

Alves

Geovanini

Brito

et al. 2007

Arq. Bras. Cardiol.

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SummaryObjective: To assess if prophylaxis with moderate doses of amiodarone in the postoperative period of cardiac surgery (coronary artery bypass grafting and/or valve surgery), reduces the incidence of atrial fibrillation in patients with high risk for developing this arrhythmia.Methods: A randomized and prospective clinical study involving 68 patients who underwent elective cardiac surgery. Mean age was 64 years and 59% of participants were males. Patients with three or more risk factors for atrial fibrillation, according to the literature, were randomized into two groups to receive or not prophylaxis with amiodarone in the first postoperative day. The dose administered ranged from 600 mg/day to 900 mg/day, intravenously, on the first postoperative day, followed by 400 mg/day orally until hospital discharge or until completing seven days. The other patients, who presented two or fewer risk factors, were followed up until hospital discharge. All patients were evaluated by means of cardiac and/or electrocardiographic monitoring.

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Alta dose de amiodarona em curto período reduz incidência de fibrilação atrial e flutter atrial no pós-operatório de cirurgia de revascularização miocárdica

Cited by 8 publications

References 15 publications

Complicações que aumentam o tempo de permanência na unidade de terapia intensiva na cirurgia cardíaca

Complicações que aumentam o tempo de permanência na unidade de terapia intensiva na cirurgia cardíaca

Application of mechanical ventilation weaning predictors after elective cardiac surgery

Prevenção de fibrilação atrial com amiodarona em moderada dosagem no pós-operatório de cirurgia cardíaca é segura e eficaz em pacientes de alto risco para desenvolver essa arritmia

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