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1.
Rev. Ciênc. Plur ; 10 (1) 2024;10(1): 31496, 2024 abr. 30. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1553549

ABSTRACT

Introdução: O período de internação os pacientes passam por um longo período de imobilização no leito, acompanhada de complicações e comorbidades que podem ocorrer no período pós-operatório. A fisioterapia aturará prevenindo os efeitos da imobilidade no leito, além de melhorar a independência funcional do paciente. Objetivo: Diante o exposto, o objetivo desse estudo é analisar as repercussões clínicas e funcionais da reabilitação precoce em pacientes submetidos à cirurgia torácica. Metodologia: Trata-se de uma revisão integrativa. Critérios de inclusão: ensaios clínicos randomizados, artigos completos, dos idiomas português, inglês e espanhol, publicados entre 2012 e 2022. Critérios de exclusão: protocolos de ensaios, ensaios não finalizados, estudos inferiores ao ano de 2012 e outras línguas. Descritores: Cirurgia torácica; Deambulação precoce; Modalidades de Fisioterapia. Com seus respectivos termos na língua inglesa. Resultados: Foram encontrados 51 artigos. Com os critérios estabelecidos foram selecionados 06 artigos. Os estudos dos autores avaliados se mostraram benéficos para a terapia de deambulação precoce combinada e exercícios. Conclusões: Os achados resultam na minimização das alterações de fluxo e volume pulmonar, otimização da mecânica do movimento tóraco-abdominal e aumento da amplitude do movimento dos músculos respiratórios, facilitando a reexpansão pulmonar e melhorando osparâmetros de função pulmonar (AU)>


Introduction: During hospitalization, patients go through a long period of immobilization in bed, accompanied by complications and comorbidities that may occur in the postoperative period. Physical therapy will help prevent the effects of immobility in bed, in addition to improving the patient's functional independence. Objective:Given the above, the objective of this study is to analyze the clinical and functional repercussions of early rehabilitation in patients undergoing thoracic surgery. Methodology:It is a systematic review. Inclusion criteria: randomized clinical trials, complete articles, in Portuguese, English and Spanish, published between 2012 and 2022. Exclusion criteria: trial protocols, unfinished trials, studies smaller than 2012 in other languages. Descriptors: Thoracic surgery; Early ambulation; Physiotherapy modalities. Results:51 articles were found. With the established criteria, 06 articles were selected. The evaluated authors' studies have shown benefit for combined early ambulation therapy and exercise. Conclusions:The findings result in the minimization of changes in lung flow and volume, optimization of the mechanics of thoracoabdominal movement and increased range of motion of the respiratory muscles, facilitating lung re-expansion and improving lung function parameters (AU).


Introducción: A lo largo de la hospitalización, los pacientes pasan por un largo período de inmovilización en cama, acompañado de complicacionesy comorbilidades que pueden presentarse en el postoperatorio. La fisioterapia ayudará a prevenir los efectos de la inmovilidad en cama, además de mejorar la independencia funcional del paciente. Objetivo:Teniendo en cuenta lo anterior, el objetivo de este estudio es analizar las repercusiones clínicas y funcionales de la rehabilitación temprana en pacientes sometidos a cirugía torácica.Metodología: Esta es una revisión sistemática. Criterios de inclusión: ensayos clínicos aleatorizados, artículos completos, en portugués, inglés y español, publicados entre 2012 y 2022. Criterios de exclusión: protocolos de ensayos, ensayos inconclusos, estudios menores a 2012 y otros idiomas. Descriptores: Cirugía torácica; Deambulación temprana; Modalidades de fisioterapia. Con sus respectivos términosen inglés.Resultados: Se encontraron 51 artículos. Fueron seleccionados 06 artículos, con los criterios establecidos. Los estudios de los autores evaluados han demostrado beneficios para la combinación de terapia de deambulación temprana y ejercicio.Conclusiones: Los hallazgos resultan en la minimización de alteraciones en el flujo y volumen pulmonar, optimización de la mecánica del movimiento toracoabdominal y aumento en el rango de movimiento de los músculos respiratorios, facilitando la reexpansión pulmonar y mejorando los parámetrosde la función pulmonar (AU).


Subject(s)
Humans , Thoracic Surgery , Physical Therapy Modalities , Early Ambulation , Social Change
2.
Rev. SOBECC (Online) ; 29: E2429910, fev. 2024.
Article in Portuguese | LILACS | ID: biblio-1555893

ABSTRACT

Objetivo: Analisar a atuação do enfermeiro perfusionista na cirurgia cardíaca. Método: Estudo exploratório com abordagem qualitativa, desenvolvida em ambiente virtual no período de 1 a 30 de junho de 2022. Amostra intencional, não probabilística, constituída de 14 enfermeiros perfusionistas. Os dados foram analisados por meio da análise de conteúdo de Bardin. Resultados: Emergiram duas categorias temáticas: Atuação do enfermeiro perfusionista na circulação extracorpórea e A relevância da interação do enfermeiro com os membros da equipe durante a cirurgia cardíaca com circulação extracorpórea. Os relatos identificaram que o enfermeiro perfusionista realiza inúmeras atribuições que vão desde o histórico de enfermagem, até o preparo e a escolha de materiais, circuitos, dispositivos e maquinários para a condução da circulação extracorpórea. Destaca-se a interação desse profissional com os demais membros da equipe no tocante à comunicação a fim de minimizar riscos e obter resultado cirúrgico positivo para o paciente. Conclusão: A atividade do enfermeiro perfusionista é complexa e necessita de um rigoroso preparo teórico-prático, especializações reconhecidas pelos órgãos competentes, bem como frequentes atualizações mesmo já sendo um profissional experiente. (AU)


Subject(s)
Humans , Thoracic Surgery , Nurses
3.
Rev. colomb. cir ; 39(1): 148-154, 20240102. fig
Article in Spanish | LILACS | ID: biblio-1526866

ABSTRACT

Introducción. La incidencia reportada de traumatismo cardíaco es baja y su grado de resolución es variable, dependiendo de la causa, el mecanismo de la lesión, el lugar donde ocurra y las características del sistema sanitario. Su incidencia ha aumentado recientemente debido al incremento de los accidentes de tránsito y la violencia, predominando los traumatismos penetrantes asociados a heridas por armas cortopunzantes y de fuego. Los traumatismos cardíacos se acompañan de un alto grado de letalidad. Caso clínico. Mujer de 35 años que consultó a emergencia por trauma torácico penetrante ocasionado por arma blanca y fue intervenida de urgencia por derrame pleural izquierdo, sin mejoría hemodinámica. Fue reevaluada detectándose derrame pericárdico con taponamiento cardíaco, ocasionado por lesión cardíaca. Fue tratada quirúrgicamente con resultados satisfactorios. Resultados. Las manifestaciones clínicas en los traumatismos penetrantes generalmente son graves y fatales, pero en algunos casos puede no comprometer tanto la hemodinamia del paciente. Para consolidar el diagnóstico clínico pueden realizarse variados estudios, siendo la ecografía FAST extendida uno de los más recomendados por su elevada sensibilidad y especificidad. Dependiendo del adelanto tecnológico del centro hospitalario y la estabilidad hemodinámica del paciente, el tratamiento quirúrgico es el más indicado. Conclusión. El conocimiento del trauma cardíaco penetrante resulta de gran importancia, no solo para el médico del servicio de emergencia sino también para el médico general. Un diagnóstico rápido y acertado, unido a un manejo adecuado, pueden ser decisivos para salvar la vida del paciente.


Introduction. The reported incidence of cardiac trauma is low and its degree of resolution is variable depending on the cause, the mechanism of injury, the place where it occurs and the characteristics of the health care system. Their incidence has currently increased due to the increase in traffic accidents and violence, with a predominance of penetrating trauma associated with stab wounds and firearms. Cardiac trauma is accompanied by a high degree of lethality. Clinical case. A 35-year-old female patient, evaluated in the emergency room for penetrating thoracic trauma caused by stab wound. She underwent emergency intervention due to left pleural effusion, but without hemodynamic improvement. She was reevaluated and pericardial effusion with cardiac tamponade caused by cardiac injury was detected. She was treated surgically with satisfactory results. Results.The clinical manifestations generally described in penetrating cardiac trauma are severe and fatal, but in some cases and due to the characteristics of the injury caused, the patient's hemodynamics may not be so compromised. To consolidate the clinical diagnosis, several complementary studies can be performed, with FAST ultrasound being one of the most recommended due to its high sensitivity and specificity. Surgical treatment is still the most indicated, depending on the technological progress of the hospital and the hemodynamic stability of the patient. Conclusions.Knowledge of penetrating cardiac trauma is of great importance, not only for the emergency department physician but also for the general practitioner. A quick and accurate diagnosis, together with adequate management can be decisive in saving the patient's life.


Subject(s)
Humans , Wounds, Penetrating , Cardiac Tamponade , Thoracic Surgery , Wounds and Injuries , Heart Injuries
5.
Cambios rev. méd ; 22 (2), 2023;22(2): 832, 16 octubre 2023. ilus, tabs.
Article in Spanish | LILACS | ID: biblio-1524835

ABSTRACT

INTRODUCCIÓN. La disección de aorta es una patología poco frecuente, cuando se presenta, lo hace de una manera catastrófica manifestada por dolor torácico o lumbar intenso acompañado de compromiso hemodinámico agudo, un diagnóstico y tratamiento temprano suelen ser cruciales para evitar la muerte del paciente, así mismo, una disección de aorta puede ser secundario a un trauma torácico por desaceleración y se presenta en 1,5% a 2%, lo que induce sobre todo a un desgarro localizado en la región del istmo aórtico. CASO CLÍNICO. Paciente masculino de 35 años, con antecedente de accidente en vehículo motorizado que provocó un traumatismo cráneo encefálico moderado, hematoma epidural parietal derecho, con resolución quirúrgica hace 18 meses, se descartó lesiones a nivel de tórax con radiografía de tórax normal, además se realizó ecografía FAST en ventana perihepática, suprapúbica, periesplénica y subxi-foidea sin encontrar alteración. Acudió al servicio de emergencia por un cuadro de hemiparesia derecha más disartria de 4 horas de evolución, se realiza tomografía de cráneo sin encontrarse lesión, catalogándose como evento cerebrovascular isquémico con recuperación neurológica. Durante su estancia hospitalaria presenta un cuadro de disnea de grandes esfuerzos y tras realizar exámenes complementarios de control se llega a una conclusión de una cardiomegalia, por lo que es referido a consulta de cardiología donde se realiza ecocardiograma, en la cual se observa disección de aorta ascendente más aneurisma por lo que se decide su ingreso y se instaura tratamiento mediante medidas de soporte, con derivación a hospital de especialidades para cirugía cardiotorácica. CONCLUSIONES. La disección de aorta secundario a un traumatis-mo es poco frecuente, sin embargo, el diagnostico siempre debe estar presente en caso de trauma por desaceleración, ya que es vital para la supervivencia del paciente y su manejo oportuno.


INTRODUCTION. Aortic dissection is an infrequent pathology; when it occurs, it does so in a catastrophic manner manifested by intense thoracic or lumbar pain accompanied by acute he-modynamic compromise. Early diagnosis and treatment are usually crucial to avoid the patient's death; likewise, aortic dissection can be secondary to thoracic trauma due to deceleration and occurs in 1.5% to 2%, which mainly induces a localized tear in the region of the aortic isthmus. CLINICAL CASE. 35-year-old male patient, with a history of motor vehicle accident that caused a moderate head injury, right parietal epidural hematoma, with surgical resolution 18 months ago, chest injuries were ruled out with normal chest X-ray, and FAST ultrasound was performed in perihepatic, suprapubic, perisplenic and subxiphoid window without finding any alteration. She went to the emergency department for a picture of right hemiparesis and dysarthria of 4 hours of evolution, a cranial tomography was performed without finding any lesion, being clas-sified as an ischemic cerebrovascular event with neurological recovery. During his hospital stay he presented with dyspnea of great effort and after performing complementary control tests, a cardiomegaly was found, so he is referred to a cardiology clinic where an echocardiogram is per-formed, which showed dissection of the ascending aorta plus aneurysm, admission is decided and treatment is instituted through supportive measures, with referral to a specialty hospital for cardiothoracic surgery. CONCLUSIONS. Aortic dissection secondary to trauma is rare, however, the diagnosis should always be present in case of trauma due to deceleration, as it is vital for the survival of the patient and its timely treatment.


Subject(s)
Humans , Male , Adult , Thoracic Surgery , Wounds and Injuries , Deceleration , Traffic Trauma Care , Dissection, Thoracic Aorta , Aneurysm , Chest Pain , Accidents, Traffic , Low Back Pain , Cardiomegaly , Dyspnea , Ecuador , Brain Injuries, Traumatic
6.
Rev. Ciênc. Méd. Biol. (Impr.) ; 22(1): 162-168, jun 22, 2023. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1451610

ABSTRACT

Introdução: as cirurgias cardíacas são as intervenções de escolha em níveis mais avançados das doenças cardiovasculares, e complicações pulmonares podem ocorrer como consequência das alterações fisiológicas causadas pela circulação extracorpórea, pela anestesia e pela incisão esterno torácica. A fisioterapia atua com o intuito de prevenir e tratar essas complicações, através da utilização de uma das técnicas de expansão pulmonar mais utilizadas na reversão de hipoxemia e atelectasias, a manobra de recrutamento alveolar, com o objetivo de abrir alvéolos colapsados e aumentar as trocas gasosas. Objetivo: revisar sistematicamente os efeitos da manobra, na relação PaO2/FiO2, SatO2, o tempo de ventilação mecânica, o tempo de internamento, a incidência de atelectasia, a pressão arterial média e a frequência cardíaca. Metodologia: revisão de ensaios clínicos controlados e randomizados nas bases de dados PubMed, Cochrane Library, LILACS e PEDro. Foram incluídos estudos que utilizaram a manobra como prevenção de complicações pulmonares, publicados em inglês e português. Resultados: foram incluídos 4 estudos, publicados entre os anos 2005 e 2017. O nível de pressão da manobra variou entre 30 cmH2O a 40 cmH2O. Os estudos mostraram que a manobra foi estatisticamente relevante na relação PaO2/FiO2, SatO2 e na redução da incidência de atelectasias, sem impacto no tempo de ventilação mecânica, no tempo de internamento, na pressão arterial média e na frequência cardíaca. Conclusão: a manobra de recrutamento pode ser considerada como uma técnica a ser utilizada na prevenção de alterações pulmonares, porém não é possível afirmar se os benefícios da manobra perduraram em longo prazo.


Introduction: Cardiac surgeries are the interventions of choice in more advanced levels of cardiovascular disease, and pulmonary complications can occur as a result of physiological changes caused by cardiopulmonary bypass, anaesthesia and the sternum thoracic incision. Physiotherapy acts with the aim of preventing and treating these complications, through the use of one of the most used lung expansion techniques in the reversal of hypoxemia and atelectasis, the alveolar recruitment maneuver, with the objective of opening collapsed alveoli and increasing gas exchanges. Objective: To systematically review the effects of the maneuver on the PaO2/FiO2 ratio, SatO2, duration of mechanical ventilation, length of hospitalization, incidence of atelectasis, mean arterial pressure and heart rate. Methodology: Review of controlled and randomized clinical trials in PubMed, Cochrane Library, LILACS and PEDro databases. Studies that used the maneuver to prevent pulmonary complications, published in English and Portuguese, were included. Results: 4 studies, published between 2005 and 2017, were included. The maneuver pressure level ranged from 30 cmH2O to 40 cmH2O. The studies showed that the maneuver was statistically relevant in relation to PaO2/FiO2, SatO2 and in reducing the incidence of atelectasis, with no impact on the duration of mechanical ventilation, length of hospitalization, mean arterial pressure and heart rate. Conclusion: The recruitment maneuver can be considered as a technique to be used in the prevention of pulmonary alterations; however, it is not possible to state whether the benefits of the maneuver lasted in the long term.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Thoracic Surgery , Cardiovascular Diseases , Positive-Pressure Respiration , Randomized Controlled Trials as Topic
7.
Rev. cuba. cir ; 62(2)jun. 2023.
Article in Spanish | LILACS, CUMED | ID: biblio-1530086

ABSTRACT

Introducción: En Cuba existen numerosos cirujanos que han dedicado una gran parte de su vida profesional a la cirugía del tórax no cardiovascular, pero solo ostentan el título de especialista de primer o segundo grado en cirugía general. Objetivo: Exponer los argumentos que demuestren la necesidad de crear e implementar la especialización de primer grado en cirugía torácica general o la maestría en cirugía del tórax. Métodos: Se realizó una búsqueda documental a partir de los motores de búsqueda de información científica Google Académico y Highwire Press. De la Web of Science, PubMed, Lilacs y Scopus se seleccionaron 23 artículos relacionados directamente con el objetivo propuesto. Desarrollo: En 2008 el profesor Benito Saínz Menéndez publicó un artículo en el cual expuso la necesidad de crear un programa de posgrado sobre cirugía torácica general; sin embargo, después de 14 años, aún se mantiene el debate sobre este tema. En tal sentido, los reclamos de la comunidad quirúrgica cubana en la propuesta de un programa de maestría y en una tesis doctoral se han hecho sentir en varias reuniones académicas y en diversas publicaciones. La nueva solicitud se justifica desde distintas aristas. Conclusión: El desarrollo de la educación de posgrado y la necesidad de formar recursos humanos capacitados en cirugía general ha acumulado los suficientes preceptos para solicitar la cirugía torácica como una subespecialidad o la inserción de una maestría sobre este tema. Se recomienda que se evalúe la posibilidad de la creación e implementación de la especialización o maestría en cirugía de tórax no cardiovascular(AU)


Introduction: In Cuba, there are numerous surgeons who have dedicated a large part of their professional life to noncardiovascular thoracic surgery, but they only hold the title of first- or second-degree specialist in General Surgery. Objective: To present the fundamentals demonstrating the need to create and implement the first-degree residence for general thoracic surgery or a master's degree in thoracic surgery. Methods: A document search was carried out using the scientific information search engines Google Scholar and Highwire Press. From the Web of Science, PubMed, Lilacs and Scopus, 23 articles directly related to the proposed objective were selected. Development: In 2008, Professor Benito Saínz Menéndez published an article in which he presented the need to create a postgraduate curriculum for general thoracic surgery; however, after 14 years, the debate on this subject is still ongoing. In this respect, the claims of the Cuban surgical community concerning the proposal of a master's program and a doctoral dissertation have been felt in several academic meetings, as well as in several publications. The new request is justified from different points of view. Conclusion: Through the development of postgraduate education and the need to train skilled human resources in general surgery, enough principles have been accumulated for requesting that thoracic surgery be taught as a subspecialty, or the insertion of a master's degree on this subject. The assessment is recommended for the possibility of creating and implementing a specialization or a master's degree in noncardiovascular thoracic surgery(AU)


Subject(s)
Humans , Thoracic Surgery/methods , Education, Medical, Graduate/methods , Review Literature as Topic , Databases, Bibliographic
8.
Rev. chil. cardiol ; 42(1): 31-36, abr. 2023. tab
Article in Spanish | LILACS | ID: biblio-1441374

ABSTRACT

Introducción: Los tumores cardíacos primarios se caracterizan por su baja prevalencia, son principalmente mixomas y se presentan frecuentemente de forma asintomática. Objetivos: Identificar el tipo histológico más común, edad de presentación, tipo de cirugías y sobrevida de un grupo de pacientes tratados por Tumores Cardíacos Primarios (TCP) en el Hospital Regional de Temuco. Métodos: Revisión de fichas clínicas de 14 pacientes portadores de TCP entre marzo 2015 y diciembre 2021. Resultados: El tipo histológico más común fue el mixoma (85,7%), seguido por el fibroelastomas papilar (14,3%). La edad promedio fue 62 años (39-85), 9 fueron mujeres y 5 hombres. Los antecedentes mórbidos más comunes fueron: Insuficiencia Cardíaca Congestiva (ICC), Hipertensión Arterial (HTA) y Accidente Vascular Encefálico (AVE). La localización anatómica más común fue la Aurícula izquierda (92%). El tratamiento en el 92% de los casos fue resección aislada y en el 7% restante resección y reparación con parche. Conclusiones: Nuestros resultados son concordantes con la literatura.


Background: primary cardiac tumors are characterized by a low prevalence. Most of them are myxomas and asymptomatic. Aim: To describe the most common histological type, the age of presentation, type of surgery performed and survival of a group of patients operated on for Primary Cardiac Tumors (PCT) in the Hospital Regional de Temuco (Chile). Methods: Review of clinical records of 14 patients with PCT operated on between March 2015 and December 2021. Results: By far the most common histological type was a myxoma (85.7%), followed by a papillary fibroelastoma (14.3%). Mean age was 62 years (39-85), 9 were women and 5 men. The most common associated medical conditions were Congestive Heart Failure (CHF), Arterial Hypertension and Stroke The usual anatomical location was the left atrium (92%). Surgical treatment was isolated resection in 92% of cases and along with a patch repair in the remaining patient. Conclusion: good results were obtained, similar to those described in the literature.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Thoracic Surgery/statistics & numerical data , Heart Neoplasms/surgery , Heart Neoplasms/epidemiology , Thoracic Surgery/methods , Survival Analysis , Longitudinal Studies , Cardiac Papillary Fibroelastoma/surgery , Cardiac Papillary Fibroelastoma/epidemiology , Length of Stay , Myxoma/surgery , Myxoma/epidemiology
9.
Rev. colomb. cir ; 38(2): 243-251, 20230303. tab, fig
Article in Spanish | LILACS | ID: biblio-1417774

ABSTRACT

Introducción. La lobectomía pulmonar es uno de los procedimientos más frecuentes en la cirugía torácica en Colombia y a nivel mundial. El objetivo de este estudio fue proporcionar información sobre el comportamiento clínico de los individuos sometidos a este tipo de cirugías. Métodos. Estudio observacional retrospectivo en un Hospital Universitario de Cali, Colombia, que incluyó todos los pacientes sometidos a lobectomía pulmonar, por causas benignas o malignas, entre los años 2010 y 2020. La información se extrajo del registro institucional de cirugía de tórax, obteniendo datos demográficos, clínicos y patológicos. Resultados. Se evaluaron los registros clínicos de 207 individuos. El 55,5 % eran mujeres, la edad promedio fue 58 años y el 41 % tuvieron antecedente de tabaquismo. En el 51,6 % de los casos se diagnosticaron neoplasias, de las cuales el 47,8 % eran primarias de pulmón, siendo el adenocarcinoma el subtipo más común. Las enfermedades benignas no tumorales representaron el 48,3 % de los casos y la causa más frecuente fueron las infecciones, dentro de las que se incluyeron 17 casos de tuberculosis pulmonar. La técnica más frecuente fue la cirugía toracoscópica video asistida (82,6 %). Presentaron un porcentaje de reintervención del 5,8 %, 10,6 % de complicaciones severas y una mortalidad hospitalaria del 4,3 %. Conclusión. La población evaluada muestra una carga alta de comorbilidades y riesgo operatorio elevado; de forma consecuente, al compararla con otras series internacionales, se encontró un porcentaje mayor de complicaciones perioperatorias y mortalidad.


Introduction. The pulmonary lobectomies is one of the most common procedures in thoracic surgery in Colombia and worldwide. The objective of this study is to provide information on the clinical behavior of individuals who underwent this type of surgeries. Methods. Retrospective observational study at a University Hospital in Cali, Colombia, including all individuals who had pulmonary lobectomies, between the years 2010 to 2020 for benign and malignant causes. The information was extracted from the institutional registry of thoracic surgery, obtaining demographic, clinical and pathological data. Results. The clinical records of 207 individuals were evaluated, 55.5% were women, the average age was 58 years, and 41% had a history of smoking. Of these cases, 51.6% were diagnosed with neoplasms, of which 47.8% were primary lung neoplasms, with adenocarcinoma being the most common subtype. As for benign diseases, they represented 48.3% of the cases and the most frequent cause was infections, including 17 cases of pulmonary tuberculosis. The most frequent technique was video-assisted thoracoscopic surgery in 82.6%, with a reoperation rate of 5.8%, up to 10.6% of severe complications, a median hospital stay of 6 days, and a hospital mortality of 4.3%.Conclusion. The population evaluated shows a high burden of comorbidities and high operative risk; consequently, when compared with other international series, it shows a higher percentage of perioperative complications, hospital stay, and mortality.


Subject(s)
Humans , Thoracic Surgery , Lung Diseases , Postoperative Complications , Thoracoscopy , Mortality , Thoracic Surgery, Video-Assisted
10.
Braz. J. Anesth. (Impr.) ; 73(1): 16-24, Jan.-Feb. 2023. tab, graf
Article in English | LILACS | ID: biblio-1420646

ABSTRACT

Abstract Objective To analyze the effects of an ERAS program on complication rates, readmission, and length of stay in patients undergoing pulmonary resection in a tertiary university hospital. Methods Ambispective cohort study with a prospective arm of 50 patients undergoing thoracic surgery within an ERAS program (ERAS group) versus a retrospective arm of 50 patients undergoing surgery before the protocol was implemented (Standard group). The primary outcome was the number of patients with 30-day surgical complications. Secondary outcomes included ERAS adherence, non-surgical complications, mortality, readmission, reintervention rate, pain, and hospital length of stay. We performed a multivariate logistic analysis to study the correlation between outcomes and ERAS adherence. Results In the univariate analysis, we found no difference between the two groups in terms of surgical complications (Standard 18 [36%] vs. ERAS 12 [24%], p = 0.19). In the ERAS group, only the readmission rate was significantly lower (Standard 15 [30%] vs. ERAS 6 [12%], p = 0.03). In the multivariate analysis, ERAS adherence was the only factor associated with a reduction in surgical complications (OR [95% CI] = 0.02 [0.00, 0.59], p = 0.03) and length of stay (HR [95% CI] = 18.5 [4.39, 78.4], p < 0.001). Conclusions The ERAS program significantly reduced the readmission rate at our hospital. Adherence to the ERAS protocol reduced surgical complications and length of stay.


Subject(s)
Humans , Postoperative Complications/etiology , Postoperative Complications/prevention & control , Postoperative Complications/epidemiology , Thoracic Surgery , Prospective Studies , Retrospective Studies , Cohort Studies , Hospitals , Length of Stay
11.
Chinese Journal of Lung Cancer ; (12): 338-347, 2023.
Article in Chinese | WPRIM | ID: wpr-982165

ABSTRACT

Lung cancer is the highest cancer-related mortality rate in the world, and is one of the most common malignancies. The standard treatment for early-stage non-small cell lung cancer (NSCLC) is radical lobectomy, while recent studies have found that sub-lobectomy of pulmonary nodules (≤2 cm) is not inferior to lobectomy and even improve the prognosis of the patients. These important findings will effectively and positively promote the formation of consensus and principles of wedge resection of pulmonary nodules (≤2 cm) in the field of thoracic surgery. The purpose of this study is to present a national expert consensus on wedge resection of pulmonary nodules (≤2 cm) in the field of thoracic surgery. The experts from Editorial Committee of Consensus on Wedge Resection of Lung Nodules (≤2 cm) (2023 Edition) jointly participated in the revision work. According to the clinical progress about the wedge resection of pulmonary nodules (≤2 cm) at home and abroad during recent years, experts jointly wrote Wedge Resection of Pulmonary Nodules (≤2 cm): a Consensus Statement by Specialists of Thoracic Surgery (2023 Edition), in combination with the homogeneous treatment principles of wedge resection in the field of thoracic surgery in China. This consensus was summarized from the following aspects: (1) Indications of wedge resection of pulmonary nodules (≤2 cm); (2) Resection range of pulmonary nodules (≤2 cm) required for wedge resection; (3) Excisable pulmonary nodules (≤2 cm) for wedge resection. This consensus finally put forward 8 recommended opinions, and sorted out 5 opinions which were still controversial and needed more evidence. The integrated opinions were generated through the discussion held among the experts of thoracic surgery from all over the country, making wedge resection of pulmonary nodules (≤2 cm) more appropriate for China and more standardized and homogeneous for clinical practice. In the future, more relevant researches should be accumulated based on the characteristics of lung cancer and its diagnosis and treatment in China, optimizing the treatment of pulmonary nodules (≤2 cm).


Subject(s)
Humans , Thoracic Surgery , Carcinoma, Non-Small-Cell Lung , Lung Neoplasms/surgery , Thoracic Surgical Procedures , Multiple Pulmonary Nodules , Small Cell Lung Carcinoma
12.
Rev. baiana enferm ; 37: e48540, 2023. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1529696

ABSTRACT

Objetivo: avaliar o coping religioso-espiritual em pacientes no período pré-operatório de cirurgia cardíaca. Método: estudo transversal, analítico, no qual foram avaliados 62 pacientes internados no período pré-operatório de cirurgia cardíaca, entre os meses setembro e dezembro de 2020, em dois hospitais de referência em cirurgia cardíaca no Nordeste do Brasil. Resultados: os pacientes apresentaram um alto uso do coping religioso-espiritual total, com predominância para o positivo. Os principais fatores utilizados para o coping religioso-espiritual positivo foram Posição positiva frente a Deus e Afastamento através Deus/Religião/Espiritualidade. Conclusão: os enfermeiros podem considerar e investir em intervenções que favoreçam o coping positivo, visando repercutir melhor experiência do paciente diante de estressores importantes, como a cirurgia cardíaca.


Objetivo: evaluar el coping religioso-espiritual en pacientes en el período preoperatorio de cirugía cardíaca. Método: estudio transversal, analítico, en el cual fueron evaluados 62 pacientes internados en el período preoperatorio de cirugía cardíaca, entre los meses septiembre y diciembre de 2020, en dos hospitales de referencia en cirugía cardíaca en el nordeste de Brasil. Resultados: los pacientes presentaron un alto uso del coping religioso-espiritual total, con predominio para el positivo. Los principales factores utilizados para el coping religioso-espiritual positivo fueron Posición positiva frente a Dios y Alejamiento a través de Dios/Religión/Espiritualidad. Conclusión: los enfermeros pueden considerar e invertir en intervenciones que favorezcan el afrontamiento positivo, buscando repercutir mejor experiencia del paciente ante estresantes importantes, como la cirugía cardíaca.


Objective: to evaluate the religious-spiritual coping in patients in the preoperative period of cardiac surgery. Method: cross-sectional, analytical study, in which 62 patients hospitalized in the preoperative period of cardiac surgery, between September and December 2020, in two reference hospitals in cardiac surgery in northeastern Brazil, were evaluated. Results: the patients showed a high use of religious-spiritual coping, with predominance for the positive. The main factors used for positive religious-spiritual coping were Positive position towards God and Distancing through God/Religion/Spirituality. Conclusion: nurses can consider and invest in interventions that favor positive coping, aiming to reflect better patient experience in the face of important stressors, such as cardiac surgery.


Subject(s)
Humans , Male , Female , Religion and Medicine , Thoracic Surgery , Preoperative Period , Cross-Sectional Studies
13.
Ribeirão Preto; s.n; out.2023. 161 p.
Thesis in Portuguese | LILACS, BDENF | ID: biblio-1555131

ABSTRACT

Introdução: As doenças valvares representam a segunda maior indicação de intervenções cirúrgicas cardíacas no Brasil e no mundo. Nesse sentido, a avaliação da qualidade de vida relacionada à saúde (QVRS) após a correção cirúrgica de valvopatias, por meio de instrumentos de medidas em saúde específicos e válidos para este público, tem se tornado emergente na prática clínica, com vistas à avaliação do referido construto. Durante a revisão de literatura, encontramos o Health-Related Quality of Life Questionnaire - HeartQoL, validado em diversos países e em distintos idiomas, todavia, o mesmo não foi adaptado para o português falado no Brasil com esta população específica. Objetivo: O objetivo do estudo foi realizar a adaptação transcultural e analisar as propriedades psicométricas do HeartQoL com indivíduos brasileiros submetidos à correção cirúrgica de valvopatias. Método: Trata-se de estudo metodológico, apreciado pelos Comitês de Ética em Pesquisa das instituições envolvidas. O processo de adaptação transcultural foi realizado conforme o referencial teórico adotado. As amostras consecutivas e não probabilísticas foram constituídas, nas três etapas, por pacientes atendidos no Ambulatório de Valvopatias do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. A coleta de dados ocorreu entre 2022 e 2023, por meio de entrevistas, com 30 pacientes, para a análise semântica do questionário, com outros 30 pacientes, para a realização do pré-teste, e com 140 pacientes, para avaliação das propriedades psicométricas. A validade de construto foi realizada por meio da correlação de Spearman entre o escore global e os domínios do HeartQoL, com os componentes físico e mental do Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). A validade estrutural, ou dimensionalidade, foi realizada pela análise fatorial confirmatória, e a avaliação da confiabilidade, por meio do coeficiente de alfa de Cronbach, para a verificação da consistência interna. Para as análises, foi adotado o nível de significância de 5%. Resultados: A versão adaptada para o português falado no Brasil apresentou-se equivalente à versão original em inglês do questionário. Apresentou evidências de validade de conteúdo a partir da avaliação do comitê de juízes e do pré-teste na amostra elegível para essa etapa. Além disso, apresentou evidências de validade de construto convergente, com correlações positivas e de forte magnitude entre o domínios físico do HeartQoL e o componente físico do SF-36, e entre o domínio emocional do HeartQoL e o componente mental do SF-36. Também apresentou evidências de validade estrutural a partir da confirmação do modelo estrutural com 14 itens e dois domínios e com índices de ajustes satisfatórios (x2 = 118,85; g.l. = 76; p = 0,0012; RMSEA = 0,0635; SRMR = 0,0440; CFI = 0,9604; TLI = 0,9526). Apresentou evidência de confiabilidade a partir do coeficiente de alfa de Cronbach, com valores satisfatórios na avaliação global (α = 0,93) e na avaliação por domínio (físico: α = 0,92; emocional: α = 0,83). Conclusão: O questionário está adaptado culturalmente para o português falado no Brasil, e possui evidências de validade e de confiabilidade comparáveis à versão original quando testadas em pacientes após a correção cirúrgica de valvopatias.


Introduction: Valve diseases represent the second major indication for cardiac surgery in Brazil and worldwide. In this regard, the assessment of health-related quality of life (HRQoL) after valve surgery repair, through specific and valid health measurement instruments for this public, has become emerging in clinical practice, with a view to assessing the said construct. During the literature review, we found the Health-Related Quality of Life Questionnaire - HeartQoL, validated in several countries and in different languages, however, it was not adapted to Brazilian Portuguese with this specific population. Objective: The study aimed to carry out the cross-cultural adaptation and analyze the psychometric properties of HeartQoL with Brazilian individuals undergoing valve surgery repair. Method: This is a methodological study, assessed by the Research Ethics Committees of the institutions involved. The cross-cultural adaptation process was carried out according to the adopted theoretical framework. Consecutive and non-probabilistic samples were constituted, in the three stages, by patients assisted at the Valvopathies Ambulatory of the Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Data collection took place between 2022 and 2023, through interviews, with 30 patients, for the semantic analysis of the questionnaire, with another 30 patients, for the pre-test, and with 140 patients, for assessing psychometric properties. Construct validity was performed using Spearman's correlation between the global score and the HeartQoL domains, with the physical and mental components of the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). Structural validity, or dimensionality, was performed using confirmatory factor analysis, and reliability was assessed using Cronbach's alpha coefficient to verify internal consistency. For the analyses, a significance level of 5% was adopted. Results: The adapted version for Brazilian Portuguese was equivalent to the original English version of the questionnaire. It presented evidence of content validity based on assessment by committee of judges and the pre-test in the sample eligible for this stage. Moreover, it presented evidence of convergent construct validity with positive and strong correlations between the HeartQoL physical domains and the SF-36 physical component, and between the HeartQoL emotional domain and the SF-36 mental component. It also presented evidence of structural validity from the confirmation of the structural model with 14 items and two domains and with satisfactory adjustment indices (x2 = 118.85; g.l. = 76; p = 0.0012; RMSEA = 0.0635; SRMR = 0.0440; CFI = 0.9604; TLI = 0.9526). It showed evidence of reliability based on Cronbach's alpha coefficient, with satisfactory values in the global assessment (α = 0.93) and in the assessment by domain (physical: α = 0.92; emotional: α = 0.83). Conclusion: The questionnaire is culturally adapted to Brazilian Portuguese, and has evidence of validity and reliability comparable to the original version when tested in patients after valve surgery repair.


Subject(s)
Humans , Quality of Life , Thoracic Surgery , Cross-Cultural Comparison , Validation Study , Aortic Valve Disease
14.
Cambios rev med ; 21(2): 861, 30 Diciembre 2022. ilus.
Article in Spanish | LILACS | ID: biblio-1415640

ABSTRACT

INTRODUCCIÓN. Las enfermedades valvulares cardíacas han sido un foco de estudio y de evolución continua, pues existen grupos de pacientes seleccionados en quienes el cambio valvular es parte de su terapéutica. En 1960 surgió el modelo de prótesis de válvula en forma de esfera enjaulada de Albert Starr y Lowell Edwards. El diseño fue perfeccionándose y es usado hasta la actualidad ya que muestra resultados clínicos aceptables. OBJETIVO. Describir el caso de un paciente portador, de uno de los primeros prototipos de prótesis valvular cardiaca metálica Starr-Edwards vigente y funcional por más de 40 años. CASO CLÍNICO. Paciente masculino con prótesis Starr-Edwards en posición aórtica, quien hasta la fecha lleva más de 40 años de uso, mantiene la clase funcional II de la New York Heart Association, realizando anticoagulación con Warfarina así como controles estrictos del índice internacional normalizado. DISCUSIÓN. Es primordial la evaluación y seguimiento de portadores de prótesis valvular para analizar anifestaciones clínicas (disnea) y hallazgos en los exámenes de laboratorio o de imagen (ecografía) para el control clínico y hemodinámica del paciente, con la intención de contemplar circunstancias que podrían determinar la nueva intervención valvular. CONCLUSIONES. Las válvulas metálicas, en particular las del tipo de prótesis de Starr-Edwards presentan alto riesgo trombótico por lo que es recomendable mantener anticoagulación plena evitando valores de índice internacional normalizado muy elevados que podrían crear escenarios de eventos hemorrágicos. Varios pacientes portadores de una de las prótesis más antiguas como es el modelo la prótesis Starr-Edwards, pueden llegar a tener una mejor supervivencia y resultados clínicos aceptables.


INTRODUCTION. Cardiac valve diseases have been a focus of study and continuous evolution, since there are selected groups of patients in whom valve replacement is part of their therapy. In 1960, the caged sphere valve prosthesis model of Albert Starr and Lowell Edwards was developed. The design was refined and is still used today because it shows acceptable clinical results. OBJECTIVE. To describe the case of a patient with one of the first prototypes of Starr- Edwards metallic heart valve prosthesis, which has been in use and functional for more than 40 years. CLINICAL CASE. Male patient with Starr-Edwards prosthesis in aortic position, who to date has been used for more than 40 years, maintains functional class II of the New York Heart Association, performing anticoagulation with Warfarin as well as strict controls of the international normalized index. DISCUSSION. The evaluation and follow-up of valve prosthesis carriers is essential to analyze clinical manifestations (dyspnea) and findings in laboratory or imaging tests (ultrasound) for the clinical and hemodynamic control of the patient, with the intention of contemplating circumstances that could determine the new valve intervention. CONCLUSIONS. Metallic valves, particularly those of the Starr-Edwards prosthesis type, present a high thrombotic risk and it is therefore advisable to maintain full anticoagulation, avoiding very high values of the international normalized index that could create scenarios of hemorrhagic events. Several patients carrying one of the older prostheses, such as the Starr-Edwards prosthesis model, may have better survival and acceptable clinical results.


Subject(s)
Humans , Male , Aged , Aortic Valve , Postoperative Complications , Reoperation , Heart Valve Prosthesis , Heart Valve Prosthesis Implantation , Cardiac Surgical Procedures , Quality of Life , Rheumatic Heart Disease , Atrial Fibrillation , Thoracic Surgery , Survival Analysis , Ecuador , Endocarditis , Aortic Valve Disease , Mitral Valve Stenosis
15.
Rev. Ciênc. Méd. Biol. (Impr.) ; 21(3): 520-528, 20221229. fig, tab
Article in English | LILACS | ID: biblio-1416174

ABSTRACT

Introducion: given the great variability in ventilation protocols, postoperative management, characteristics of the alveolar recruitment maneuver (ARM) (frequency, duration and intensity) and tolerability in patients undergoing cardiac surgery (CS), this study investigates whether ARM is beneficial in this area. situation in order to standardize its use. Objective: we investigated the effectiveness of ARM against pulmonary complications (PCs) immediately after CS. Methods: this randomised clinical trial included 134 patients aged >18 years who underwent coronary artery bypass graft or valve replacement surgery at our institution between February and September 2019. Participants were allocated to receive standard physiotherapy (control group [CG], n=67) or standard physiotherapy plus ARM (intervention group [IG], n=67). Results: there was no statistically significant difference in the incidence of PCs between the CG and IG groups (p=0.85). ARM did not improve gas exchange or lower total mechanical ventilation time, reintubation requirement, or intensive care unit and hospital stay. Conclusions: prophylactic ARM does not decrease the insufficiency of PCs in the postoperative period of CS, it did not improve gas exchange, nor did it reduce the time of MV. MRA was associated with an increased risk of hemodynamic instability. Patients must be screened before performing ARM.


Introdução: dada a grande variabilidade nos protocolos de ventilação, manejo pós-operatório, características da manobra de recrutamento alveolar (MRA) (frequência, duração e intensidade) e tolerabilidade em pacientes submetidos à cirurgia cardíaca (CC), este estudo investiga se a MRA é benéfica nesta área, a fim de padronizar seu uso. Objetivo: investigou-se a eficácia da MRA contra complicações pulmonares (CPs) imediatamente após a CC. Metodologia: este ensaio clínico randomizado incluiu 134 pacientes com idade > 18 anos submetidos à cirurgia de revascularização do miocárdio ou cirurgia de substituição valvar em nossa instituição entre fevereiro e setembro de 2019. Os participantes foram alocados para receber fisioterapia padrão (grupo controle [GC], n=67) ou fisioterapia padrão com adição da MRA (grupo intervenção [GI], n=67). Resultados: não houve diferença estatisticamente significativa na incidência de CPs entre os grupos GC e GI (p=0,85). A MRA não melhorou as trocas gasosas ou reduziu o tempo total de ventilação mecânica, necessidade de reintubação na unidade de terapia intensiva e internação hospitalar. Conclusão: a MRA profilática não diminui a incidência de CPs no pós-operatório de CC, não melhora as trocas gasosas, nem reduziu o tempo de VM. A MRA foi associada a um risco aumentado de instabilidade hemodinâmica. Os pacientes devem ser avaliados antes de realizar MRA.


Subject(s)
Humans , Male , Female , Adult , Thoracic Surgery , Intermittent Positive-Pressure Ventilation , Physical Therapy Modalities , Drug-Related Side Effects and Adverse Reactions
16.
Rev. chil. cardiol ; 41(3): 206-215, dic. 2022. ilus, tab
Article in Spanish | LILACS | ID: biblio-1423686

ABSTRACT

La cirugía a "corazón abierto" con circulación extracorpórea se apronta a cumplir 70 años. Desde un comienzo se hizo necesario buscar la forma de tener un campo operatorio quieto y exangüe, sin riesgo de embolia aérea, lo que llevó al desarrollo de la primera "cardioplegía" por Melrose, a fines de los años 1950's. Sin embargo, esta cayó en descrédito rápidamente y fue abandonada en años 1960's. Se necesitó que transcurrieran casi 15 años para el retorno de la cardioplegía, ahora como forma de proteger al corazón de la isquemia. Durante este periodo se volvió a la fibrilación ventricular a la perfusión coronaria, al paro isquémico y a la hipotermia tópica. Sin embargo, algunos investigadores mantuvieron su interés en la cardioplegía, facilitando el retorno clínico de esta con Hearse en 1976, con la solución cardioplégica cristaloide del Hospital St. Thomas, la que se asentó como el principal método de protección miocárdica, hasta la irrupción de Buckberg con su cardioplegía sanguínea en multidosis, la que se convirtió, a comienzo de los años 1990's, en el procedimiento preferido para proteger al corazón durante el periodo de isquemia requerido para operar en él, infundida ahora no solo por vía anterógrada, sino que también por vía retrógrada. Esto, hasta Pedro Del Nido y su vuelta a la dosis única, solo por vía anterógrada.


Open heart surgery with extracorporeal circulation is approaching its 70th anniversary. From the beginning it was necessary to find a way to have a still and bloodless operative field, without the risk of air embolism, which led to the development of the first "cardioplegía" by Melrose, at the end of the 1950's. However, it quickly fell into disrepute and was abandoned in the 1960's. It took almost 15 years for cardioplegía to return, now as a way of protecting the heart from ischemia. During this period, ventricular fibrillation, coronary perfusion, ischemic arrest and topical hypothermia returned. However, some investigators maintained their interest in cardioplegía, facilitating the clinical return of cardioplegía with Hearse in 1976, with the crystalloid cardioplegic solution of St. Thomas's Hospital. This became the main method of myocardial protection until the irruption of Buckberg with his multidose blood cardioplegía, which became, at the beginning of the 90's, the preferred method to protect the heart during the ischemic period required to operate on it, now infused not only by anterograde route but also by retrograde route. This, until Pedro Del Nido and his return to the single dose, only via the antegrade route.


Subject(s)
Humans , History, 20th Century , History, 21st Century , Thoracic Surgery/history , Myocardial Ischemia/prevention & control , Heart Arrest, Induced/history
17.
Medisan ; 26(6)dic. 2022. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1440548

ABSTRACT

Introducción: Entre las diferentes complicaciones que surgen en el periodo posoperatorio inmediato, el bajo gasto cardíaco presenta mayor morbilidad y mortalidad asociadas, con una incidencia de hasta 45,0 %. Objetivo: Determinar los factores relacionados con la aparición posoperatoria del bajo gasto cardíaco en pacientes con tratamiento quirúrgico cardiovascular y circulación extracorpórea, según variables demográficas, clínicas y ecocardiográficas. Métodos: Se realizó una investigación analítica, de casos y controles, la cual incluyó a pacientes que recibieron tratamiento quirúrgico cardíaco en el Servicio de Cardiología y Cirugía Cardiovascular del Hospital Provincial Clinicoquirúrgico Docente Saturnino Lora de Santiago de Cuba, desde enero hasta diciembre de 2019. Cada grupo de estudio estuvo conformado por 43 integrantes, para lo cual se consideró la presencia del síndrome de bajo gasto cardíaco (casos) o no (controles). Resultados: En la serie predominaron los pacientes menores de 65 años de edad en ambos grupos de estudio (51,2 y 73,5 % para casos y controles, respectivamente), así como el sexo masculino (60,9 %); de igual modo, resultó más frecuente la intervención quirúrgica de emergencia (80,2 %). La fibrilación auricular y la función sistólica del ventrículo derecho presentaron alta significación estadística (p<0,05). Conclusiones: Algunos elementos clínicos y ecocardiográficos (edad, fibrilación auricular, función sistólica de los ventrículos izquierdo y derecho, así como intervención quirúrgica de emergencia) se asociaron de manera independiente a la aparición del bajo gasto cardíaco.


Introduction: Among the different complications that arise in the immediate postoperative period, the low cardiac output presents higher associated morbidity and mortality, with an incidence of up to 45.0 %. Objective: To determine the factors related to the postoperative emergence of the low cardiac output in patients with cardiovascular surgical treatment and extracorporeal circulation, according to demographic, clinical and echocardiographic variables. Methods: An analytic, cases and controls investigation was carried out, which included patients that received heart surgical treatment in the Cardiology and Cardiovascular Surgery Service of Saturnino Lora Teaching Clinical Surgical Provincial Hospital in Santiago de Cuba, from January to December, 2019. Each study group was conformed by 43 members, for which was considered the presence (cases) or not (controls) of the low cardiac output syndrome. Results: In the series there was a prevalence of the patients under 65 years in both study groups (51.2 and 73.5 % for cases and controls, respectively), as well as the male sex (60.9 %); in a same way, the emergency surgical intervention was the most frequent (80.2 %). The atrial fibrillation and the systolic function of the right ventricle presented high statistical significance (p <0.05). Conclusions: Some clinical and echocardiographic elements (age, atrial fibrillation, systolic function of the left and right ventricles, as well as emergency surgical intervention) were associated in an independent way with the emergence of the low cardiac output.


Subject(s)
Cardiac Output, Low , Ventricular Dysfunction , Thoracic Surgery , Extracorporeal Circulation
18.
J. Health Biol. Sci. (Online) ; 10(1): 1-7, 01/jan./2022. tab, ilus
Article in Portuguese | LILACS | ID: biblio-1411521

ABSTRACT

Objetivo: analisar o perfil epidemiológico dos casos de neoplasia do sistema respiratório que foram diagnosticados e tratados nos anos de 2017 a 2019 e comparar com os casos ocorridos durante a pandemia da COVID-19 no Brasil. Método: estudo transversal com dados de neoplasia maligna da traqueia, dos brônquios e dos pulmões fornecidos pelo Departamento de Informática do Sistema Único de Saúde. Os casos foram coletados e analisados conforme a modalidade terapêutica e o sexo, por meio da incidência anual para cada região brasileira, comparando-se o período da pandemia e os anos de 2017, 2018 e 2019. Resultados: durante a pandemia, nos casos de neoplasias do sistema respiratório, que acometeram o sexo masculino, foram observadas reduções da realização de procedimentos terapêuticos em todas as regiões brasileiras, notando-se, principalmente, diminuições de 68,22%, 19,58% e 57,24% dos casos tratados com cirurgias, quimioterapia e radioterapia na Região Nordeste. Nos casos de neoplasias que acometeram o sexo feminino, foram detectados aumentos de cirurgias e reduções de radioterapia em todas as regiões federativas, notando-se, principalmente, um aumento de 64,03% e uma redução de 59,73%, respectivamente, dos casos tratados com cirurgia no Centro-Oeste e com radioterapia no Sudeste. Conclusão: o remanejamento dos tratamentos está correlacionado aos aumentos e às reduções dos casos tratados de neoplasias do sistema respiratório. Nesse contexto, os serviços de saúde devem adotar medidas para reduzir a exposição e a contaminação dos indivíduos com a COVID-19, de modo que os tratamentos oncológicos não sejam afetados, e evitar desfechos graves.


Objective: to analyze the epidemiological profile of cases of neoplasms of the respiratory system, which were diagnosed and treated in the years 2017 to 2019, and to compare with the cases that occurred during the COVID-19 pandemic in Brazil. Method: a cross-sectional study with data on the malignant neoplasm of the trachea, bronchi, and lungs provided by the Department of Informatics of the Unified Health System. The cases were collected and analyzed according to the therapeutic modality and sex through the annual incidence for each Brazilian region, comparing the period of the pandemic and the years 2017, 2018, and 2019. Results: during the pandemic, cases of respiratory system neoplasms that affected males and reductions in the performance of therapeutic procedures were observed in all Brazilian regions, noting mainly, decreases of 68.22%, 19.58%, and 57.24% of cases treated with surgeries, chemotherapy, and radiotherapy in the Northeast region. In the cases of neoplasms that affected females, increases in surgeries and reductions in radiotherapy were detected in all federative regions, noting, mainly, an increase of 64.03% and a reduction of 59.73%, respectively, of the cases treated with surgery in the Midwest and with radiotherapy in the Southeast. Conclusion: the relocation of treatments is correlated with increases and decreases in cases of treated respiratory system neoplasms. In this context, health services must adopt measures to reduce the exposure and contamination of individuals with COVID-19 so that cancer treatments are not affected and avoid serious outcomes.


Subject(s)
COVID-19 , Lung Neoplasms , Radiotherapy , Respiratory System , Thoracic Surgery , Bronchi , Outcome Assessment, Health Care , Pandemics , International Cooperation , Lung , Neoplasms
19.
Arq. ciências saúde UNIPAR ; 26(3): 748-763, set-dez. 2022.
Article in Portuguese | LILACS | ID: biblio-1399462

ABSTRACT

Introdução: Pacientes submetidos a grandes cirurgias abdominais apresentam riscos de complicações pós-operatórias. A mobilização precoce vem sendo implementada e cada vez mais aplicada, no intuito de prevenir esses eventos. Objetivo: Demonstrar se a mobilização precoce está associada à melhor funcionalidade no pós-operatório de cirurgias abdominais. Métodos: Revisão integrativa de literatura realizada por meio de uma busca bibliográfica junto aos bancos de dados: BVS, Scielo, PedRO e Pubmed por meio dos descritores: mobilização precoce, deambulação precoce, cuidados pós-operatórios, período pós-operatório, estado funcional, exercício físico, reabilitação, funcionalidade e cirurgia abdominal, nos idiomas inglês, português e espanhol. Resultados: A amostra final foi constituída por 08 artigos científicos, que foram estruturados em forma de quadro para apresentação de suas principais características, dos métodos e os principais resultados. Conclusão: A mobilização precoce está associada ao retorno rápido à funcionalidade da linha de base pré- operatória, as atividades de vida diária, independência funcional, além do tempo de internação mais curto e menor duração dos desagradáveis sintomas pós-operatórios.


Introduction: Patients undergoing major abdominal surgery are at risk of postoperative complications. Early mobilization has been implemented and increasingly applied in order to prevent these events. Objective: to demonstrate whether early mobilization is associated with better functionality in the postoperative period of abdominal surgeries. Methods: an integrative literature review carried out through a literature search in the following databases: BVS, Scielo, PedRO and Pubmed using the descriptors: early mobilization, early ambulation, postoperative care, postoperative period, functional status, physical exercise, rehabilitation, functionality and abdominal surgery, in English, Portuguese and Spanish. Results: The final sample consisted of 08 scientific articles, which were structured in the form of a table to present their main characteristics, methods and main results. Conclusion: Early mobilization interferes with the rapid return to preoperative baseline functionality, activities of daily living, functional independence, in addition to a shorter hospital stay and shorter duration of unpleasant postoperative symptoms.


Introducción: Los pacientes sometidos a cirugías abdominales mayores corren el riesgo de sufrir complicaciones postoperatorias. La movilización temprana se ha implementado y aplicado cada vez más para prevenir estos eventos. Objetivo: Demostrar si la movilización temprana se asocia con una mejor funcionalidad después de la cirugía abdominal. Métodos: Revisión bibliográfica integrativa realizada a través de una búsqueda bibliográfica en las siguientes bases de datos: BVS, Scielo, PedRO y Pubmed utilizando los descriptores: early mobilisation, early ambulation, postoperative care, postoperative period, functional status, physical exercise, rehabilitation, functionality and abdominal surgery, en inglés, portugués y español. Resultados: La muestra final consistió en 08 artículos científicos, que se estructuraron en forma de tabla para presentar sus principales características, los métodos y los principales resultados. Conclusión: La movilización temprana se asocia con un rápido retorno a la funcionalidad de base preoperatoria, a las actividades de la vida diaria, a la independencia funcional, así como a una estancia hospitalaria más corta y a una menor duración de los síntomas postoperatorios desagradables.


Subject(s)
Humans , Male , Female , Adult , Postoperative Care , Thoracic Surgery , Early Ambulation , Postoperative Complications , Postoperative Period , Rehabilitation , Exercise , Libraries, Digital , Abdomen , Functional Status
20.
Rev. baiana saúde pública ; 46(3): 10-23, 20220930.
Article in Portuguese | LILACS | ID: biblio-1417560

ABSTRACT

As cirurgias cardíacas têm o potencial de diminuir a mortalidade e melhorar a qualidade de vida dos pacientes. Por isso, conhecer o cenário das cirurgias cardíacas locais contribui para o desenvolvimento e a melhoria da assistência. O trabalho objetiva descrever o cenário dos procedimentos cirúrgicos cardiovasculares realizados na região compreendida por Juazeiro (BA) e Petrolina (PE), no período entre 2008 e 2020. Trata-se de um estudo observacional, transversal e descritivo, com base em informações extraídas do Sistema de Informações Hospitalares do Sistema Único de Saúde (SUS), que consiste em um banco de dados público. Foram avaliados 702 procedimentos cirúrgicos, dentre eles 386 (55%) foram de cirurgia de revascularização miocárdica (CRM), 202 (28,8%) de cirurgia valvar isolada e 114 (16,2%) de outros tipos. Houve aumento da permanência hospitalar no período analisado. Foi observado aumento da mortalidade e média de permanência hospitalar nos momentos de decréscimo no valor de financiamento e número de intervenções. Não foi observado aumento sustentado do número de procedimentos, a despeito do incremento populacional de 9,5% no período. O financiamento e o volume de procedimentos foram instáveis no período de 2008 a 2020 no Sertão do São Francisco. O menor repasse financeiro esteve associado à redução do número de procedimentos, potencialmente restringindo o acesso a pacientes com necessidades mais urgentes. Em consequência, houve aumento da mortalidade e do tempo de internação nos períodos de menor financiamento.


Cardiac surgeries have the potential to reduce mortality and improve quality of life of patients. Thus, knowing the scenario of local cardiac surgeries contributes to the development and improvement of care. This work aims to describe the scenario of cardiovascular surgical procedures performed in the region comprising Juazeiro (BA) and Petrolina (PE), between 2008 and 2020. It is an observational, cross-sectional, and descriptive study based on information extracted from the Hospital Information System of the Sistema Único de Saúde (SUS), which is a public database. We evaluated 702 surgical procedures, among which 386 (55%) were of coronary artery bypass grafting (CABG), 202 (28.8%) of isolated valve surgery, and 114 (16.2%) others. There was an increase in hospital stay in the analyzed period. An increase in mortality and mean hospital stay was observed in moments of decrease in the value of funding and number of interventions. No sustained increase in the number of procedures was observed, despite the 9.5% population increase in the period. Funding and volume of procedures were unstable in the period from 2008 to 2020 in the Sertão do São Francisco. The lower financial transfer was associated with a reduction in the number of procedures, potentially restricting access to patients with more urgent needs. As a result, mortality and hospitalization time increased in the periods of lower funding.


Las cirugías cardíacas pueden reducir la mortalidad y mejorar la calidad de vida de los pacientes. Así conocer el panorama de las cirugías cardíacas locales contribuye al desarrollo y la mejora de la atención. Este trabajo pretende describir el panorama de los procedimientos quirúrgicos cardiovasculares realizados en la región sanitaria que comprende Juazeiro (Bahía, Brasil) y Petrolina (Pernambuco, Brasil), entre 2008 y 2020. Se trata de un estudio observacional, transversal y descriptivo, basado en información del Sistema de Información Hospitalaria del Sistema Único de Saúde (SUS) que consiste en una base de datos pública. Se evaluaron 702 procedimientos quirúrgicos, de los cuales 386 (55%) fueron de cirugía de revascularización coronaria (CABG), 202 (28,8%) de cirugía valvular aislada y 114 (16,2%) de otro tipo. Hubo un aumento de la estancia hospitalaria en el periodo analizado. Se observó una alza de la mortalidad y de la estancia media en el hospital cuando se redujo el valor de la financiación y el número de intervenciones. No se observó un aumento en el número de procedimientos, a pesar del incremento del 9,5% de la población en el periodo. La financiación y el volumen de procedimientos fueron inestables de 2008 a 2020 en el Sertão do São Francisco. La menor transferencia financiera se asoció a una reducción del número de procedimientos, lo que podría restringir el acceso a los pacientes con necesidades más urgentes. En consecuencia, se produjo un aumento de la mortalidad y de la duración de la estancia hospitalaria en los periodos de menor financiación.


Subject(s)
Thoracic Surgery , Capital Financing , Mortality/trends , Health Policy
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