3rd GUIDELINE FOR PERIOPERATIVE CARDIOVASCULAR EVALUATION OF THE BRAZILIAN SOCIETY OF CARDIOLOGY

Gualandro, Danielle Menosi; Yu, Pai Ching; Caramelli, Bruno; Marques, Ana Paula; Calderaro, Daniela; Fornari, Lucimara Fabiana; Pinho, Claudio; Feitosa, Alina Coutinho Rodrigues; Polanczyk, Carísi Anne; Rochitte, Carlos Eduardo; Jardim, Carlos; Vieira, Carolina L.Z.; Nakamura, Denise Moral; Iezzi, D; Schreen, Dirk; Adam, Eduardo Leal; D'Ámico, Elbio Antônio; Lima, Emerson Quintino de; Burdmann, Emmanuel A.; Mateo, Enrique Indalécio Pachón; Marcondes‐Braga, Fabiana G.; Machado, Fábio Prates; Paula, Flávio Jota de; Carmo, Gabriel Assis Lopes do; Feitosa-Filho, Gilson Soares; Prado, Gustavo Faibischew; Lopes, Heno Ferreira; Fernandes, João Ricardo Cordeiro; Lima, José Jaime Galvão de; Sacilotto, Luciana; Drager, Luciano F.; Vacanti, Luciano Janussi; Rohde, Luís Eduardo Paim; Prada, Luis; Gowdak, Luís Henrique Wolff; Vieira, Marcelo Luiz Campos; Monachini, Maristela C.; Macatrão-Costa, Milena Frota; Paixão, Milena Ribeiro; Oliveira, Múcio Tavares de; Cury, Patrícia Ramos; Villaça, Paula Ribeiro; Farsky, Pedro Sílvio; Siciliano, Rinaldo Focaccia; Heinisch, Roberto Henrique; Souza, Rogério; Gualandro, Sandra Fátima Menosi; Accorsi, Tarso Augusto Duenhas; Júnior, Wilson Mathias

doi:10.5935/abc.20170140

Cited by 53 publications

(69 citation statements)

References 629 publications

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“…Febbo et al 27 reported that the number of postoperative bleeding complications increased as the number of teeth extracted increased. In contrast, Gualandro et al 28 recommended continuation of antiplatelet therapy in patients undergoing multiple tooth extractions, biopsy, flap surgery, gingivectomy, or alveoloplasty. These researchers suggested that the usual dose of warfarin could be continued in patients undergoing extraction of up to 5 teeth or installation of up to 6 implants.…”

Section: Discussionmentioning

confidence: 99%

When do we need more than local compression to control intraoral haemorrhage?

Sohn

Lee

Han

et al. 2019

JKAOMS

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J Korean Assoc Oral Maxillofac Surg 2019;45:343-350) Objectives: The aims of this study were to determine the effectiveness of local compression in patients presenting to the emergency room with intraoral bleeding and to identify when complex haemostatic measures may be required. Materials and Methods: Five hundred forty patients who had experienced intraoral haemorrhage were retrospectively reviewed. The outcome variable was the haemostasis method used, i.e., simple (local compression with gauze) or complex (an alternative method after local compression has failed). Predictor variables were sex, age, American Society of Anesthesiologists (ASA) class, hepatic cirrhosis, bleeding disorder, use of antithrombotic agents, and site/cause of haemorrhage. Results: The mean patient age was 48.9±23.9 years, 53.5% were male, 42.8% were ASA class II or higher, and 23.7% were taking antithrombotic agents. Local compression was used most often (68.1%), followed by local haemostatic agents, sutures, systemic tranexamic acid or blood products, and electrocautery. The most common site of bleeding was the gingiva (91.7%), and the most common cause was tooth extraction (45.7%). Risk factors for needing a complex haemostasis method were use of antithrombotic agents (odds ratio 2.047, P=0.009) and minor oral surgery (excluding extraction and implant procedures; odds ratio 6.081, P=0.001). Conclusion: A haemostasis method other than local compression may be needed in patients taking antithrombotic agents or having undergone minor oral surgery.

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Section: Discussionmentioning

confidence: 99%

When do we need more than local compression to control intraoral haemorrhage?

Sohn

Lee

Han

et al. 2019

JKAOMS

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“…5 The routine use of resting echocardiography as a risk stratification tool is discouraged, and is considered a class III recommendation according to the II Guidelines on Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology, 2011. 6 …”

Section: Introductionmentioning

confidence: 99%

Utility of Ultraportable Echocardiography in the Preoperative Evaluation of Noncardiac Surgery

Costa¹,

Almeida²,

Estrada³

et al. 2016

Arquivos Brasileiros De Cardiologia

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BackgroundThe ultraportable echocardiogram machine, with relevant portability and easiness in performing diagnoses, when in experienced hands, may contribute to the reliability of preoperative evaluation in noncardiac surgeries.ObjectivesTo assess cardiac function parameters in patients aged older than 60 years, candidates of elective noncardiac surgeries, classified as ASA1 or ASA 2 according to surgical risk.MethodsA total of 211 patients referred for elective surgeries, without suspicion of previous heart diseases, were included in the study. Assessment of patients was conducted by conventional echocardiogram using the ultraportable V Scan (GE) device right after the pre-anesthetic clinical evaluation. We assessed the clinical impact of echocardiography results by using a questionnaire addressed to the anesthetist.ResultsMean age of patients was 68.9 ± 7.0 years, 154 were women. The most frequent surgeries were: a) facectomy - cataract - 18; b) inguinal hernia surgery - 18; c) Cholecystectomy - 16. We found 58 normal tests (27.5%), 70 (33.2%) with mild valve reflux, and 83 (39.3%) with relevant abnormality, such as increase in heart chamber size, global and/or segmental contractile dysfunction, significant valve dysfunction or other unspecified. Test results caused delay of surgical procedure for a more detailed cardiac evaluation in 20 (9.5%) patients, and change in anesthetic management in 7 (3.3%).ConclusionThere was a considerable clinical impact with the use of the ultraportable echocardiography, since one out of every ten patients evaluated had their clinical management changed due to the detection of previously unsuspected, significant heart diseases, with the potential for severe complications.

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“…proposto, adiar ou até cancelar a cirurgia. [1][2][3] Estima-se que cerca de 40 milhões de cirurgias sejam realizadas anualmente somente na Europa e 240 milhões em todo mundo. 4,5 Neste contexto, as complicações cardiovasculares no perioperatório são de suma importância.…”

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“…[11][12][13] De um modo geral, o risco cardiovascular de uma cirurgia pode ser estimado levando-se em consideração as condições clínicas do paciente, a capacidade funcional e os riscos intrínsecos associados ao procedimento. 2 Entretanto, a quantificação deste risco é muitas vezes difícil de ser mensurada, especialmente naqueles pacientes com doenças de apresentação subclínica, nem sempre detectadas nas avaliações rotineiras. As principais diretrizes mundiais sobre cuidados perioperatórios são enfáticas em recomendar uma cautelosa anamnese e minucioso exame clínico, a fim de detectar os principais grupos de risco.…”

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“…85 Por esses motivos, recomenda-se que todos os pacientes de risco cardiovascular intermediário a alto sejam submetidos a dosagens seriadas de troponina até 72 horas após procedimento, independente da presença de sintomas. 2,86 Excetuando-se as elevações isoladas de troponina, a ocorrência de eventos cardiovasculares foi de 6,4% (8 eventos), semelhante ao encontrado por Fisher e colaboradores (6,0%…”

Section: Listas De Abreviaturasunclassified

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Uso do índice tornozelo-braquial como preditor de eventos cardiovasculares no pós-operatório de cirurgias não cardíacas

Carmo¹

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3rd GUIDELINE FOR PERIOPERATIVE CARDIOVASCULAR EVALUATION OF THE BRAZILIAN SOCIETY OF CARDIOLOGY

Cited by 53 publications

References 629 publications

When do we need more than local compression to control intraoral haemorrhage?

When do we need more than local compression to control intraoral haemorrhage?

Utility of Ultraportable Echocardiography in the Preoperative Evaluation of Noncardiac Surgery

Uso do índice tornozelo-braquial como preditor de eventos cardiovasculares no pós-operatório de cirurgias não cardíacas

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