Circulação extracorpórea em adultos no século XXI: ciência, arte ou empirismo?

Mota, Andre Lupp; Rodrigues, Alfredo José; Évora, Paulo Roberto Barbosa

doi:10.1590/s0102-76382008000100013

Cited by 21 publications

(18 citation statements)

References 38 publications

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“…Many factors during CPB, as the exposure of blood to nonphysiologic conditions and surfaces and the increase of pulsatile flow in a continuous stream, results in the development of SIRS [20]. This limited biocompatibility of materials causes multiorgan dysfunction after systemic perfusion, expressed by myocardial depression, vasomotor dysfunction, respiratory, renal and hepatic failure, cognitive imbalance and of thermal regulation for coagulopathy for bleeding, which characterizes the SIRS.…”

Section: Discussionmentioning

confidence: 99%

Clinical and functional capacity of patients with dilated cardiomyopathy after four years of transplantation

Mont’Alverne¹,

Galdino²,

Pinheiro³

et al. 2012

Revista Brasileira De Cirurgia Cardiovascular

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Objective: To evaluate patient with cardiomyopathy's progress after cardiac transplant, by analyzing his survival, complications and cardiovascular responses after nearly four years of surgery.Methods: The survey was conducted from February to May 2011, with patients undergoing cardiac transplantation at Dr. Carlos Alberto Studart Gomes Hospital -Messejana Hospital (HDM). The sample consisted of all transplanted patients in 2007 in this hospital. Initially an evaluation form developed by the researchers, which was based on collected data from patients' medical records, was applied, about trans and postoperative period. After collecting these informations, patients underwent the six-minute walk test (6WT). The marks found in walking distance were compared with reference marks expected for this population by using Enright and Sherrill's equation.Results: From all the 24 patients who underwent cardiac transplantation in HDM in 2007, 14 were evaluated and 10 were excluded. Regarding the complications, in the transoperatory period, the most evident was the right ventricular dysfunction (64.3%) and tachycardia (64.3%) was more evident on the postoperative period. Analyzing the 6WT it was observed a decrease of 11.6% in walking distance when compared with the estimated distance (486 ± 55 m, 550 ± 59 m, respectively).Conclusion: Survival of heart transplant patients was equivalent to about 70%. The results of this study before the 6WT showed that patients' cardiovascular responses are below the estimated, nevertheless within the normal range established.Descriptors: Cardiomyopathies. Cardiomyopathy, dilated. Heart transplantation. Walking. 563Rev Bras Cir Cardiovasc 2012;27(4) :562-9 Mont'Alverne DGB, et al. -Clinical and functional capacity of patients with dilated cardiomyopathy after four years

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Section: Discussionmentioning

confidence: 99%

Clinical and functional capacity of patients with dilated cardiomyopathy after four years of transplantation

Mont’Alverne¹,

Galdino²,

Pinheiro³

et al. 2012

Revista Brasileira De Cirurgia Cardiovascular

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“…(1) . A harmonia usualmente existente entre processos bioquímicos, hormonais e celulares pode ser corrompida por eventos patológicos inerentes à CEC, como lesão endotelial, lesão de isquemia-reperfusão e, sobretudo, pronunciada liberação de citocinas, moléculas de adesão celular e fatores de necrose tecidual (8) . …”

Section: O Papel Dos Neutrófilosunclassified

Responses of human body attached to use the bypass: literature review / Respostas do organismo humano inerentes ao uso da circulação extracorpórea: revisão de literatura

Araujo¹,

Sabino²,

Sousa

et al. 2014

Rev Enferm UFPI

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Objective: literature review on changes of human body in response to triggered use of cardiopulmonary bypass and emphasize the complications. Methodology: this was a study of integrative literature available on the subject: human body and answers of postoperative complications to use the inherent CPB. were conducted research textbooks to bypass in database online scielo, pubmed, lilacs, and other sources such as site of the brazilian society of bypass, site of the brazilian society of cardiology and references cited in articles obtained. Results: bypass provided a great advancement of cardiac surgery in the world, becoming an essential to approach procedure of a series of cardiac until then, without possibility of surgical therapy. Furthermore, cardiopulmonary bypass is capable of producing a wide variety of changes in human body, and postoperative complications which contribute to increased postoperative morbidity. Conclusions: although the practice of cardiopulmonary bypass affect the normal operating model of human body, the surgeon provides the opportunity to work in the correction of defects, that otherwise would be impossible to correct. Descriptors: Extracorporoeal circulation. Systemic Inflammatory Response Syndrome.Postoperative care RESUMO Objetivo: revisar na literatura as alterações do organismo humano desencadeadas em resposta ao uso da circulação extracorpórea. Metodologia: tratou-se de um estudo de revisão da literatura integrativa disponível sobre o tema: respostas do organismo humano e complicações pós-operatórias inerentes ao uso da circulação extracorpórea. Foram realizadas pesquisas em livros didáticos de circulação extracorpórea, em base de dados on-line scielo, pubmed, lilacs, e em outras fontes tais como site da sociedade brasileira de circulação extracorpórea, site da sociedade brasileira de cardiologia, site da sociedade brasileira de cirurgia cardiovascular e referências citadas nos artigos obtidos. Resultados: a circulação extracorpórea proporcionou um grande avanço da cirurgia cardíaca em todo o mundo, tornando-se um procedimento essencial para abordagem de uma série de cardiopatias, até então, sem possibilidades de terapêutica cirúrgica. Além disso, é capaz de produzir uma grande variedade de alterações no organismo humano, bem como complicações pós-operatórias, o que contribui para o aumento da morbidade pós-operatória. Conclusão: embora a prática da circulação extracorpórea afete o modelo normal de funcionamento do organismo humano, proporciona ao cirurgião a oportunidade de trabalhar na correção de defeitos, que de outra forma, seriam impossíveis de corrigir. Palavras-chave: Circulação extracorpórea. Sindrome da Resposta Inflamatória Sistêmica. Cuidados pós-operatórios. RESUMEN Objetivo: revisión de la literatura sobre los cambios del cuerpo humano en respuesta a dispara el uso de circulación extracorpórea. Metodología: se realizó un estudio de la literatura integrado disponible en el asunto: cuerpo humano y respuestas de complicaciones postoperatorias inherentes de uso d...

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“…Thus, there is synergism between various pro-inflammatory mechanisms, culminating in violation of homeostasis. Harmony usually between biochemical, hormonal and cellular processes, can be corrupted by pathological events related to the CPB, such as endothelial injury, ischemia-reperfusion, and especially pronounced release of cytokines, adhesion molecules and tissue necrosis factor [1].…”

Section: Introductionmentioning

confidence: 99%

Revascularização miocárdica com circulação extracorpórea; aspectos bioquímicos, hormonais e celulares

Gabriel¹,

Locali²,

Matsuoka³

et al. 2011

Rev Bras Cir Cardiovasc

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Revascularização miocárdica com circulação extracorpórea; aspectos bioquímicos, hormonais e celularesOn-pump coronary artery bypass graft surgery: biochemical, hormonal and cellular features This study was carried out at Federal University of São Paulo, Discipline of Cardiovascular Surgery, São Paulo, SP, Brazil. Methods: Eighteen patients underwent on-pump CABG surgery. Mean time of CPB was 80.3 minutes. Hormonal, biochemical and cellular measurements were taken in some time points -preoperatively, immediately after coming off CPB, 24 and 48 hours postoperatively. Friedman and Wilcoxon tests were applied based on significance level of 5%.Results: There was activation and significant elevation of total leukocytes and neutrophils count over CPB, remaining this way up to 48 hours postoperatively. Total platelets count, in turn, was marked by relevant reduction immediately after coming off CPB as well as in two postoperative time points. Serum levels of total proteins and albumin, immediately after coming off CPB and also in two postoperative time points, were significantly decreased comparing with preoperative status. There was remarkable reduction of total T3, free T3 and total T4 particularly up to first 24 hours postoperatively.Conclusion: In on-pump CABG surgery, inflammatory effects encompass activation of total leukocytes, neutrophils and platelets, reduction of serum level of total proteins and albumin and decreased thyroid hormones levels, especially within first postoperative 24 hours.

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Circulação extracorpórea em adultos no século XXI: ciência, arte ou empirismo?

Cited by 21 publications

References 38 publications

Clinical and functional capacity of patients with dilated cardiomyopathy after four years of transplantation

Clinical and functional capacity of patients with dilated cardiomyopathy after four years of transplantation

Responses of human body attached to use the bypass: literature review / Respostas do organismo humano inerentes ao uso da circulação extracorpórea: revisão de literatura

Revascularização miocárdica com circulação extracorpórea; aspectos bioquímicos, hormonais e celulares

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