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1.
Arq Bras Cardiol ; 114(1): 45-46, 2020 Jan.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32049169
2.
Sci Rep ; 9(1): 14975, 2019 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-31628390

RESUMO

Data on predictors of intraoperative cardiac arrest (ICA) outcomes are scarce in the literature. This study analysed predictors of poor outcome and their prognostic value after an ICA. Clinical and laboratory data before and 24 hours (h) after ICA were analysed as predictors for no return of spontaneous circulation (ROSC) and 24 h and 1-year mortality. Receiver operating characteristic curves for each predictor and sensitivity, specificity, positive and negative likelihood ratios, and post-test probability were calculated. A total of 167,574 anaesthetic procedures were performed, including 158 cases of ICAs. Based on the predictors for no ROSC, a threshold of 13 minutes of ICA yielded the highest area under curve (AUC) (0.867[0.80-0.93]), with a sensitivity and specificity of 78.4% [69.6-86.3%] and 89.3% [80.4-96.4%], respectively. For the 1-year mortality, the GCS without the verbal component 24 h after an ICA had the highest AUC (0.616 [0.792-0.956]), with a sensitivity of 79.3% [65.5-93.1%] and specificity of 86.1 [74.4-95.4]. ICA duration and GCS 24 h after the event had the best prognostic value for no ROSC and 1-year mortality. For 24 h mortality, no predictors had prognostic value.

3.
Arq Bras Cardiol ; 113(3): 449-663, 2019 Oct 10.
Artigo em Português | MEDLINE | ID: mdl-31621787
4.
Bernoche, Claudia; Timerman, Sergio; Polastri, Thatiane Facholi; Giannetti, Natali Schiavo; Siqueira, Adailson Wagner da Silva; Piscopo, Agnaldo; Soeiro, Alexandre de Matos; Reis, Amélia Gorete Afonso da Costa; Tanaka, Ana Cristina Sayuri; Thomaz, Ana Maria; Quilici, Ana Paula; Catarino, Andrei Hilário; Ribeiro, Anna Christina de Lima; Barreto, Antonio Carlos Pereira; Azevedo, Antonio Fernando Barros de Filho; Pazin, Antonio Filho; Timerman, Ari; Scarpa, Bruna Romanelli; Timerman, Bruno; Tavares, Caio de Assis Moura; Martins, Cantidio Soares Lemos; Serrano, Carlos Vicente Junior; Malaque, Ceila Maria Sant'Ana; Pisani, Cristiano Faria; Batista, Daniel Valente; Leandro, Daniela Luana Fernandes; Szpilman, David; Gonçalves, Diego Manoel; Paiva, Edison Ferreira de; Osawa, Eduardo Atsushi; Lima, Eduardo Gomes; Adam, Eduardo Leal; Peixoto, Elaine; Evaristo, Eli Faria; Azeka, Estela; Silva, Fabio Bruno da; Wen, Fan Hui; Ferreira, Fatima Gil; Lima, Felipe Gallego; Fernandes, Felipe Lourenço; Ganem, Fernando; Galas, Filomena Regina Barbosa Gomes; Tarasoutchi, Flavio; Souza, Germano Emilio Conceição; Feitosa, Gilson Soares Filho; Foronda, Gustavo; Guimarães, Helio Penna; Abud, Isabela Cristina Kirnew; Leite, Ivanhoé Stuart Lima; Linhares, Jaime Paula Pessoa Filho; Moraes, Junior João Batista de Moura Xavier; Falcão, João Luiz Alencar de Araripe; Ramires, Jose Antônio Franchini; Cavalini, José Fernando; Saraiva, José Francisco Kerr; Abrão, Karen Cristine; Pinto, Lecio Figueira; Bianchi, Leonardo Luís Torres; Lopes, Leonardo Nícolau Geisler Daud; Piegas, Leopoldo Soares; Kopel, Liliane; Godoy, Lucas Colombo; Tobase, Lucia; Hajjar, Ludhmila Abrahão; Dallan, Luís Augusto Palma; Caneo, Luiz Fernando; Cardoso, Luiz Francisco; Canesin, Manoel Fernandes; Park, Marcelo; Rabelo, Marcia Maria Noya; Malachias, Marcus Vinícius Bolívar; Gonçalves, Maria Aparecida Batistão; Almeida, Maria Fernanda Branco de; Souza, Maria Francilene Silva; Favarato, Maria Helena Sampaio; Carrion, Maria Julia Machline; Gonzalez, Maria Margarita; Bortolotto, Maria Rita de Figueiredo Lemos; Macatrão-Costa, Milena Frota; Shimoda, Mônica Satsuki; Oliveira-Junior, Mucio Tavares de; Ikari, Nana Miura; Dutra, Oscar Pereira; Berwanger, Otávio; Pinheiro, Patricia Ana Paiva Corrêa; Reis, Patrícia Feitosa Frota dos; Cellia, Pedro Henrique Moraes; Santos Filho, Raul Dias dos; Gianotto-Oliveira, Renan; Kalil Filho, Roberto; Guinsburg, Ruth; Managini, Sandrigo; Lage, Silvia Helena Gelas; Yeu, So Pei; Franchi, Sonia Meiken; Shimoda-Sakano, Tania; Accorsi, Tarso Duenhas; Leal, Tatiana de Carvalho Andreucci; Guimarães, Vanessa; Sallai, Vanessa Santos; Ávila, Walkiria Samuel; Sako, Yara Kimiko.
Arq. bras. cardiol ; 113(3): 449-663, Sept. 2019. tab, graf
Artigo em Português | LILACS-Express | ID: biblio-1038561
7.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 28(3)jul.-ago. 2018. tab, graf
Artigo em Português | LILACS | ID: biblio-916551

RESUMO

Evitar novos episódios de parada cardiorrespiratória (PCR). Identificar e tratar as causas que levaram o paciente à PCR. Oferecer suportes ventilatório, hemodinâmico, neurológico e metabólico. Realizar a modulação terapêutica de temperatura para todos os pacientes que retornaram à circulação espontânea. Indicação de cateterismo cardíaco para pacientes sem causa estabelecida de PCR quando a causa pode ser um evento coronariano


Avoid further episodes of cardiopulmonary arrest (CPA). Identify and treat the causes of the patient's CPA. Provide ventilatory, hemodynamic, neurological and metabolic support. Perform therapeutic temperature modulation for all patients who have resumed spontaneous circulation. Indication of cardiac catheterization for patients with no established cause of CPA when the cause may be a coronary event


Assuntos
Humanos , Masculino , Feminino , Emergências , Parada Cardíaca/terapia , Cateterismo Cardíaco , Dopamina/uso terapêutico , Epinefrina/uso terapêutico , Isquemia , Cetose/complicações , Norepinefrina/uso terapêutico , Reperfusão , Ressuscitação/métodos , Terapêutica
9.
Int J Med Educ ; 8: 309-313, 2017 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-28850944

RESUMO

Objectives: To describe learning outcomes of undergraduate nursing students following an online basic life support course (BLS). Methods: An online BLS course was developed and administered to 94 nursing students. Pre- and post-tests were used to assess theoretical learning. Checklist simulations and feedback devices were used to assess the cardiopulmonary resuscitation (CPR) skills of the 62 students who completed the course. Results: A paired t-test revealed a significant increase in learning [pre-test (6.4 ± 1.61), post-test (9.3 ± 0.82), p < 0.001]. The increase in the average grade after taking the online course was significant (p<0.001). No learning differences (p=0.475) had been observed between 1st and 2nd year (9.20 ± 1.60), and between 3rd and 4th year (9.67 ± 0.61) students. A CPR simulation was performed after completing the course: students checked for a response (90%), exposed the chest (98%), checked for breathing (97%), called emergency services (76%), requested for a defibrillator (92%), checked for a pulse (77%), positioned their hands properly (87%), performed 30 compressions/cycle (95%), performed compressions of at least 5 cm depth (89%), released the chest (90%), applied two breaths (97%), used the automated external defibrillator (97%), and positioned the pads (100%). Conclusions: The online course was an effective method for teaching and learning key BLS skills wherein students were able to accurately apply BLS procedures during the CPR simulation. This short-term online training, which likely improves learning and self-efficacy in BLS providers, can be used for the continuing education of health professionals.


Assuntos
Reanimação Cardiopulmonar/educação , Educação em Enfermagem/métodos , Treinamento por Simulação/métodos , Estudantes de Enfermagem , Competência Clínica , Instrução por Computador/métodos , Avaliação Educacional , Feminino , Humanos , Internet , Aprendizagem , Masculino , Autoeficácia , Adulto Jovem
10.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 26(1): 27-33, jan.-mar.2016. tab, ilus
Artigo em Português | LILACS | ID: lil-789773

RESUMO

O processo fisiopatológico secundário à parada cardiorrespiratória (PCR) com retorno da circulação espontânea (RCE), determina a síndrome pós-PCR, com lesão cerebral, disfunção miocárdica e reperfusão, em resposta à isquemia orgânica. A terapia do controle da temperatura (TCT) oferece mecanismos neuroprotetores, limitação da lesão miocárdica e redução da resposta inflamatória sistêmica. Dúvidas existem em relação aos benefícios, início e duração da TCT, porém, há evidências que apoiam a melhora da sobrevida e do prognóstico neurológico em populações selecionadas. Recomenda-se a TCT por 24 horas, com controle da temperatura na faixa de 32 °C a 36 °C para adultos que sobrevivem à PCR extra-hospitalar e permanecem em coma com ritmos iniciais de fibrilação/taquicardia ventricular, o que também é sugerido para os sobreviventes de PCR extra-hospitalar com ritmo inicial não chocável e de PCR intra-hospitalar em qualquer ritmo inicial. O início do resfriamento deve ser feito o mais precocemente possível, depreferência, até 12 horas após o RCE. O controle da temperatura corpórea deve ser incorporado aos cuidados dos pacientes críticos pós-PCR, a fim de reduzir as taxas de mortalidade e de sequelas neurológicas...


The secondary pathophysiological process to cardiorespiratory arrest (CRA) with return of spontaneous circulation (ROSC), determines the post-cardiorespiratory arrest syndrome with brain injury, myocardial reperfusion and dysfunction in response to systemic ischemia. The temperature control therapy (TCT) provides neuroprotective mechanisms, limitation of myocardial injury and reduction of systemic inflammatory response. There are still some questions regarding the benefits, timing and duration of TCT, however, there is evidence supporting improved survival and neurological outcome in selected populations. TCT is recommended for 24 hours, with temperature control in the range of 32 to 36 °C for comatose adults who survive after out-of-hospital cardiorespiratory arrest with initial rates of fibrillation/ ventricular tachycardia, which is also suggested for extra-hospital cardiorespiratory arrest survivors with early pace not shockable and intra-hospital cardiorespiratory arrest in any initial rate. The beginning of the cooling should be done as early as possible, ideally up to12 hours after ROSC. The control of body temperature should be incorporated into the careof the post-CRA critically ill patients in order to reduce mortality and neurological sequelae...


Assuntos
Humanos , Masculino , Feminino , Hipotermia/complicações , Hipotermia/terapia , Parada Cardíaca/fisiopatologia , Parada Cardíaca/terapia , Temperatura Corporal , Eletrocardiografia/métodos , Qualidade de Vida , Fatores de Risco , Reperfusão Miocárdica/métodos , Sobrevida , Sistema Nervoso Central/fisiopatologia
11.
Artigo em Português | BDENF - Enfermagem | ID: bde-29961

RESUMO

Objetivo: descrever a experiência do projeto Viva Coração na cidade de Salvador, Bahia, Brasil. Método: trata-sede um relato de experiência sobre o projeto Viva Coração desenvolvido pelo SAMU 192, no qual foi realizadotreinamento da população em reanimação cardiopulmonar e distribuição de aparelho de desfibrilação para espaçosde atendimento à saúde. Resultados: foram treinadas 6.287 pessoas vinculadas a cenários como: serviços de saúde,repartições públicas, estações de transbordo e ponto turístico. O conteúdo abordado nas atividades teórico-práticas,com duração de 4 horas, baseou-se nos protocolos de ressuscitação cardiorrespiratória da American Heart Association.Foram distribuídos 200 desfibriladores para as unidades de saúde participantes. Conclusões: a experiência favoreceuo treinamento da população para atuar em situações de parada cardiorrespiratória, conhecimento que amplia aschances de intervenção e sobrevida sem sequelas e poderá subsidiar novas capacitações. (AU)


Objective: the main objective of this study was to relate the experience of the Heart Rescue Project, in the city ofSalvador, Bahia state, in Brazil. Method: the report is about an experience with the Heart Rescue Project developedby SAMU 192, in which the population was trained in cardiopulmonary resuscitation. Also, through the projectwere distributed defibrillation equipments for health care spaces. Results: were trained 6,287 people linked to placeslike health services, public agencies, transfer stations and tourist sites. The addressed content, in the theoretical andpractical activities, was based on the American Heart Association protocols for cardiopulmonary resuscitation. Tothe health units that participated in the training, 200 defibrillators were distributed. Conclusions: the populationthat received the training was stimulated to act in situations of cardiac arrest. The knowledge imparted increasesthe probability of obtaining a survival without sequelae, therefore it is believed that this would help new courses oftraining (AU)


Objetivo: el estudio tuvo por objetivo describir la experiencia del proyecto Reanimación del Corazón en la ciudad deSalvador, estado de Bahía, en Brasil. Método: se trata de un relato de la experiencia sobre el proyecto Reanimación delCorazón desarrollado por el SAMU 192, en el cual fue realizado un entrenamiento de la población en reanimacióncardiopulmonar y se distribuyeron aparatos de desfibrilación para espacios de atención a la salud. Resultados: fueron entrenadas 6.287 personas vinculadas a escenarios como: servicios de salud, reparticiones públicas, estacionesde transbordo y puntos turísticos. El contenido abordado en las actividades teórico prácticas, con duración de4 horas, se basó en los protocolos de resucitación cardiorrespiratoria de la American Heart Association. Fuerondistribuidos 200 desfibriladores para las unidades de salud participantes. Conclusiones: la experiencia favoreció elentrenamiento de la población para actuar en situaciones de parada cardiorrespiratoria, conocimiento que amplíalas probabilidades de intervención y supervivencia sin secuelas, pudiendo así auxiliar nuevas capacitaciones. (AU)


Assuntos
Humanos , Reanimação Cardiopulmonar , Primeiros Socorros , Parada Cardíaca , Educação em Saúde
12.
Int J Med Educ ; 6: 166-71, 2015 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-26590951

RESUMO

OBJECTIVE: To identify faculty perceptions of simulation insertion in the undergraduate program, considering the advantages and challenges posed by this resource. METHODS: We conducted a qualitative study with intentional sampling according to pre-defined criteria, following a semi-structured outline regarding data saturation. We have interviewed 14 healthcare instructors from a teaching institution that employs simulation in its syllabi. RESULTS: The majority of the faculty interviewed considered the use of scenario, followed by debriefing, as an excellent teaching tool. However, the faculty also noted a number of difficulties, such as the workload necessary to assemble the scenario, the correlation between scenario goals and the competences of the program, the time spent with the simulation, and the ratio of students to faculty members. CONCLUSIONS: Faculties consider simulation an effective tool in the healthcare program and maintain that the main obstacle faced by them is the logistical demand.


Assuntos
Atitude , Educação Médica/métodos , Educação em Enfermagem/métodos , Docentes , Treinamento por Simulação , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
13.
J Am Heart Assoc ; 4(10): e002185, 2015 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-26452987

RESUMO

BACKGROUND: Targeted automated external defibrillator (AED) programs have improved survival rates among patients who have an out-of-hospital cardiac arrest (OHCA) in US airports, as well as European and Japanese railways. The Sao Paulo (Brazil) Metro subway carries 4.5 million people per day. A targeted AED program was begun in the Sao Paulo Metro with the objective to improve survival from cardiac arrest. METHODS AND RESULTS: A prospective, longitudinal, observational study of all cardiac arrests in the Sao Paulo Metro was performed from September 2006 through November 2012. This study focused on cardiac arrest by ventricular arrhythmias, and the primary endpoint was survival to hospital discharge with minimal neurological impairment. A total of 62 patients had an initial cardiac rhythm of ventricular fibrillation. Because no data on cardiac arrest treatment or outcomes existed before beginning this project, the first 16 months of the implementation was used as the initial experience and compared with the subsequent 5 years of full operation. Return of spontaneous circulation was not different between the initial 16 months and the subsequent 5 years (6 of 8 [75%] vs. 39 of 54 [72%]; P=0.88). However, survival to discharge was significantly different once the full program was instituted (0 of 8 vs. 23 of 54 [43%]; P=0.001). CONCLUSIONS: Implementation of a targeted AED program in the Sao Paulo Metro subway system saved lives. A short interval between arrest and defibrillation was key for good long-term, neurologically intact survival. These results support strategic expansion of targeted AED programs in other large Latin American cities.


Assuntos
Reanimação Cardiopulmonar/instrumentação , Morte Súbita Cardíaca/prevenção & controle , Desfibriladores , Cardioversão Elétrica/instrumentação , Parada Cardíaca Extra-Hospitalar/terapia , Ferrovias , Serviços Urbanos de Saúde , Fibrilação Ventricular/terapia , Idoso , Brasil , Reanimação Cardiopulmonar/efeitos adversos , Reanimação Cardiopulmonar/mortalidade , Cardioversão Elétrica/efeitos adversos , Cardioversão Elétrica/mortalidade , Serviços Médicos de Emergência , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Parada Cardíaca Extra-Hospitalar/diagnóstico , Parada Cardíaca Extra-Hospitalar/mortalidade , Parada Cardíaca Extra-Hospitalar/fisiopatologia , Admissão do Paciente , Alta do Paciente , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Recuperação de Função Fisiológica , Fatores de Risco , Fatores de Tempo , Tempo para o Tratamento , Transporte de Pacientes , Resultado do Tratamento , Fibrilação Ventricular/diagnóstico , Fibrilação Ventricular/mortalidade , Fibrilação Ventricular/fisiopatologia
14.
Clinics (Sao Paulo) ; 70(3): 190-5, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26017650

RESUMO

OBJECTIVES: This study was designed to assess cardiopulmonary resuscitation quality and rescuer fatigue when rescuers perform one or two minutes of continuous chest compressions. METHODS: This prospective crossover study included 148 lay rescuers who were continuously trained in a cardiopulmonary resuscitation course. The subjects underwent a 120-min training program comprising continuous chest compressions. After the course, half of the volunteers performed one minute of continuous chest compressions, and the others performed two minutes, both on a manikin model. After 30 minutes, the volunteers who had previously performed one minute now performed two minutes on the same manikin and vice versa. RESULTS: A comparison of continuous chest compressions performed for one and two minutes, respectively, showed that there were significant differences in the average rate of compressions per minute (121 vs. 124), the percentage of compressions of appropriate depth (76% vs. 54%), the average depth (53 vs. 47 mm), and the number of compressions with no errors (62 vs. 47%). No parameters were significantly different when comparing participants who performed regular physical activity with those who did not and participants who had a normal body mass index with overweight/obese participants. CONCLUSION: The quality of continuous chest compressions by lay rescuers is superior when it is performed for one minute rather than for two minutes, independent of the body mass index or regular physical activity, even if they are continuously trained in cardiopulmonary resuscitation. It is beneficial to rotate rescuers every minute when performing continuous chest compressions to provide higher quality and to achieve greater success in assisting a victim of cardiac arrest.


Assuntos
Reanimação Cardiopulmonar/educação , Reanimação Cardiopulmonar/normas , Socorristas/educação , Massagem Cardíaca/normas , Adulto , Índice de Massa Corporal , Competência Clínica/normas , Estudos Cross-Over , Serviços Médicos de Emergência/normas , Exercício , Fadiga/fisiopatologia , Feminino , Parada Cardíaca/terapia , Humanos , Masculino , Manequins , Pessoa de Meia-Idade , Estudos Prospectivos , Estatísticas não Paramétricas , Fatores de Tempo
15.
Clinics ; 70(3): 190-195, 03/2015. tab, graf
Artigo em Inglês | LILACS | ID: lil-747110

RESUMO

OBJECTIVES: This study was designed to assess cardiopulmonary resuscitation quality and rescuer fatigue when rescuers perform one or two minutes of continuous chest compressions. METHODS: This prospective crossover study included 148 lay rescuers who were continuously trained in a cardiopulmonary resuscitation course. The subjects underwent a 120-min training program comprising continuous chest compressions. After the course, half of the volunteers performed one minute of continuous chest compressions, and the others performed two minutes, both on a manikin model. After 30 minutes, the volunteers who had previously performed one minute now performed two minutes on the same manikin and vice versa. RESULTS: A comparison of continuous chest compressions performed for one and two minutes, respectively, showed that there were significant differences in the average rate of compressions per minute (121 vs. 124), the percentage of compressions of appropriate depth (76% vs. 54%), the average depth (53 vs. 47 mm), and the number of compressions with no errors (62 vs. 47%). No parameters were significantly different when comparing participants who performed regular physical activity with those who did not and participants who had a normal body mass index with overweight/obese participants. CONCLUSION: The quality of continuous chest compressions by lay rescuers is superior when it is performed for one minute rather than for two minutes, independent of the body mass index or regular physical activity, even if they are continuously trained in cardiopulmonary resuscitation. It is beneficial to rotate rescuers every minute when performing continuous chest compressions to provide higher quality and to achieve greater success in assisting a victim of cardiac arrest. .


Assuntos
Feminino , Humanos , Masculino , Anticorpos Antibacterianos/sangue , Neoplasias Colorretais/virologia , Infecções por Helicobacter/sangue , Helicobacter pylori/imunologia
20.
Acad Emerg Med ; 20(12): 1289-96, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24341584

RESUMO

At the 2013 Academic Emergency Medicine global health consensus conference, a breakout session on a resuscitation research agenda was held. Two articles focusing on cardiac arrest and trauma resuscitation are the result of that discussion. This article describes the burden of disease and outcomes, issues in resuscitation research, and global trends in resuscitation research funding priorities. Globally, cardiovascular disease and trauma cause a high burden of disease that receives a disproportionately smaller research investment. International resuscitation research faces unique ethical challenges. It needs reliable baseline statistics regarding quality of care and outcomes; data linkages between providers; reliable and comparable national databases; and an effective, efficient, and sustainable resuscitation research infrastructure to advance the field. Research in resuscitation in low- and middle-income countries is needed to understand the epidemiology, infrastructure and systems context, level of training needed, and potential for cost-effective care to improve outcomes. Research is needed on low-cost models of population-based research, ways to disseminate information to the developing world, and finding the most cost-effective strategies to improve outcomes.


Assuntos
Pesquisa Biomédica/tendências , Doenças Cardiovasculares/terapia , Medicina de Emergência , Saúde Global , Pesquisa , Ressuscitação/tendências , Ferimentos e Lesões/terapia , Conferências de Consenso como Assunto , Países em Desenvolvimento , Necessidades e Demandas de Serviços de Saúde , Humanos , Pobreza , Apoio à Pesquisa como Assunto/tendências
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