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INTRODUCTION: Hemorrhagic shock is the main cause of death in the prehospital environment, which highlights the need to standardize measures aiming at bleeding control and volume replacement in this environment. In Brazil, the first prehospital packed red blood cell transfusion service started in September 2020, in Bragança Paulista, state of São Paulo. OBJECTIVES: Describe the trends and characteristics of patients who received prehospital transfusions prior to hospital treatment during the first year of operation. METHODS: A retrospective data review was made of all patients who received transfusions from the mobile intensive care unit in Bragança Paulista over one year. RESULTS: In this period, 19 patients were transfused. Since activation, the average response time was 20 min. The mean shock indexes before and after blood transfusion were 2.16 and 1.1, respectively. During the course of the 1st year of prehospital transfusions, no blood was wasted and there were no adverse effects. CONCLUSION: Introduction of the prehospital packed red blood cell transfusion service was successful, with significant improvement in hemodynamic parameters.
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OBJECTIVES: to analyze the occurrence and predisposing factors for surgical site infection in patients submitted to heart transplantation, evaluating the relationship between cases of infections and the variables related to the patient and the surgical procedure. METHOD: retrospective cohort study, with review of the medical records of patients older than 18 years submitted to heart transplantation. The correlation between variables was evaluated by using Fisher's exact test and Mann-Whitney-Wilcoxon test. RESULTS: the sample consisted of 86 patients, predominantly men, with severe systemic disease, submitted to extensive preoperative hospitalizations. Signs of surgical site infection were observed in 9.3% of transplanted patients, with five (62.5%) superficial incisional, two (25%) deep and one (12.5%) case of organ/space infection. There was no statistically significant association between the variables related to the patient and the surgery. CONCLUSION: there was no association between the studied variables and the cases of surgical site infection, possibly due to the small number of cases of infection observed in the sample investigated.
Assuntos
Transplante de Coração , Infecção da Ferida Cirúrgica/epidemiologia , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
O presente artigo objetiva compreender e investigar os sentidos atribuídos ao sentimento de gratidão por sujeitos que vivenciam a experiência de uma relação amorosa na atualidade. Esse estudo baseia-se numa pesquisa qualitativa que empregou a entrevista semidirigida como instrumento de coleta de dados, visando refletir acerca da presença e do desenvolvimento da gratidão em meio às relações amorosas em que se encontram os sujeitos no contemporâneo. Os resultados expressaram dúvidas e questionamentos, mostrando a gratidão como um sentimento difícil de ser pensado e experienciado, mas que também figura como algo presente e de grande importância na vida e relações desses sujeitos (AU).
This article aims to understand and investigate the meanings attributed to the feeling of gratitude by subjects who experience the experience of a loving relationship. This study is based on a qualitative research that used the semi-structured interview as an instrument of data collection, aiming to reflect about presence and development of gratitude in the midst of the fragile relationships that contemporary subjects find themselves. The results expressed doubts and questions, showing the gratitude as a difficult feeling to be thought as well as experienced, but which also appears as something present and of great importance in the life and relationships of these subjects (AU).
En este artículo se pretenden comprender e investigar los sentidos atribuidos al sentimiento de gratitud por sujetos que experimentan la experiencia de una relación amorosa. Este estudio se basa en una investigación cualitativa que empleó la entrevista semidirigida como instrumento de recolección de datos, para reflejar la presencia y el desarrollo de la gratitud en medio de las relaciones frágiles que se encuentran los sujetos contemporáneos. Los resultados expresaron dudas y cuestionamientos, mostrando la gratitud como un sentimiento difícil de ser pensado, pero que también figura como algo presente y de gran importancia en la vida y relaciones de esos sujetos (AU).
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Humanos , Masculino , Feminino , Adulto , Casamento/psicologia , Amor , AfetoRESUMO
Abstract Objectives: to analyze the occurrence and predisposing factors for surgical site infection in patients submitted to heart transplantation, evaluating the relationship between cases of infections and the variables related to the patient and the surgical procedure. Method: retrospective cohort study, with review of the medical records of patients older than 18 years submitted to heart transplantation. The correlation between variables was evaluated by using Fisher's exact test and Mann-Whitney-Wilcoxon test. Results: the sample consisted of 86 patients, predominantly men, with severe systemic disease, submitted to extensive preoperative hospitalizations. Signs of surgical site infection were observed in 9.3% of transplanted patients, with five (62.5%) superficial incisional, two (25%) deep and one (12.5%) case of organ/space infection. There was no statistically significant association between the variables related to the patient and the surgery. Conclusion: there was no association between the studied variables and the cases of surgical site infection, possibly due to the small number of cases of infection observed in the sample investigated.
Resumo Objetivos: analisar a ocorrência e os fatores predisponentes para infecção de sítio cirúrgico em pacientes submetidos a transplante cardíaco e verificar a relação entre os casos de infecção e as variáveis referentes ao paciente e ao procedimento cirúrgico. Método: estudo de coorte retrospectivo, com exame dos prontuários médicos de pacientes maiores de 18 anos, submetidos a transplante cardíaco. A correlação entre variáveis foi realizada por meio dos testes exato de Fischer e de Mann-Whitney-Wilcoxon. Resultados: a amostra foi constituída por 86 pacientes, predominantemente homens, com doença sistêmica grave, submetidos a internações pré-operatórias extensas. Apresentaram sinais de infecção do sítio cirúrgico 9,3% dos transplantados, sendo cinco (62,5%) incisionais superficiais, duas (25%) profundas e um (12,5%) caso de infecção de órgão/espaço. Não houve associação estatisticamente significante entre as variáveis relacionadas ao paciente e ao procedimento cirúrgico. Conclusão: não houve associação entre as variáveis estudadas e os casos de infecção do sítio cirúrgico, possivelmente relacionado ao pequeno número de casos de infecção presentes na amostra investigada.
Resumen Objetivos: analizar la incidencia y los factores predisponentes para la infección del sitio quirúrgico en pacientes sometidos a trasplante cardíaco, evaluando la relación entre los casos de infección y las variables relacionadas al paciente y al procedimiento quirúrgico. Método: estudio retrospectivo de cohortes, con una revisión de las historias clínicas de los pacientes mayores de 18 años, sometidos a trasplante cardíaco. La correlación entre las variables se evaluó mediante la prueba exacta de Fisher y la prueba de Mann-Whitney-Wilcoxon. Resultados: la muestra quedó conformada por 86 pacientes, predominantemente hombres, con enfermedad sistémica grave, sometidos a extensas hospitalizaciones preoperatorias. Se observó la infección del sitio quirúrgico en el 9,3% de los pacientes trasplantados, con cinco (62,5%) infecciones incisionales superficiales, dos (25%) profundas y un (12,5%) caso de infección órgano/espacio. No hubo asociación estadísticamente significativa entre las variables relacionadas al paciente y a la cirugía. Conclusión: no hubo asociación entre las variables estudiadas y los casos de infección del sitio quirúrgico, posiblemente debido al pequeño número de casos de infección observados en la muestra investigada.