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1.
Heart Surg Forum ; 24(1): E022-E030, 2021 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-33635255

RESUMO

BACKGROUND: Prioritization among patients with coronary artery disease represents a difficult issue during the SARS-CoV-2 pandemic. We present our clinical practices and patients' outcomes after elective, emergent, and urgent cardiovascular surgery and percutaneous coronary interventions (PCI). We also investigated the rate of nosocomial infection of SARS-CoV-2 in health workers (HWs), including surgeons after cardiovascular procedures and percutaneous interventions (PCI). MATERIAL AND METHODS: We performed 186 cardiovascular operations and PCI between March 15 and October 15. According to the level of priority (LoP), we performed urgent and emergent coronary artery bypass grafting (CABG) and cardiac valve repair or replacement surgery in 44 patients. In one patient with acute chordae rupture with pulmonary edema, we performed mitral valve replacement. We performed the aortic arch repair in two patients with type-I aortic dissection in urgent situations. Therefore, in 47 patients we performed cardiac operations in urgent or emergent situations. Elective CABG (N = 28) and elective cardiac valve (N = 10) surgeries were performed (total: 38). While rescue PCI was urgently performed in 47 patients with ST-segment elevation myocardial infarction (STEMI), it was performed in elective or emergent situations in 40 patients with myocardial ischemia. Endovascular treatment was performed in four patients with deep venous thrombosis (DVT) and in four patients with chronic arterial occlusion, respectively. Surgical vascular repair and embolectomy were performed in patients with peripheral artery injury (N = 6) and acute arterial embolic events (N = 4), respectively. We performed thoracic computed tomography followed by reverse transcriptase-polymerase chain reaction (RT-PCR) test in patients with irregular diffuse reticular opacities with or without consolidation on chest X-ray. Blood coagulation disorders including d-dimer, thromboplastin time (TT), and partial thromboplastin time (aPTT) were measured prior to procedures. RESULTS: No mortality and morbidity was seen after percutaneous and surgical arterial or venous procedures. The total mortality rate was 4.1% (8 of 186 CAD patients or valve surgery) after urgent and emergent CABG (N = 4), an urgent valve replacement (N = 1), and PCI (N = 3). Low cardiac output syndrome (LOS) and major adverse cardiac cerebrovascular event (MACCE) were the mortality factors after cardiac surgery. The reasons for death after PCI were sudden cardiac arrest related to the dissection of the left main coronary artery during procedure and pneumonia due to COVID-19 (N = 2). Ground-glass opacities in combination with pulmonary consolidations were detected in seven patients. Interlobular septal and pleural thickening with patchy bronchiectasis in the bilateral lower lobe involvement was found after thoracic computed tomography in these patients. We confirmed in-hospital COVID-19 using a PCR test in two patients with STEMI prior to PCI. PT and aPTT increased, but fibrin degradation products did not in those two patients. We confirmed COVID-19 via phone call in six CABG patients and one PCI patient after discharge from the hospital. None of the patients diagnosed with COVID-19 died after being discharged from the hospital. CONCLUSION: Cardiovascular surgery and PCI can safely be performed with acceptable complications and mortality rates in elective situations, during the COVID-19 pandemic. Preoperative control of OR traffic, careful evaluation of the patient's history, consultation, and precautions taken by healthcare professionals are important, during and after procedures. Also important is wearing a mask and face shield and careful disinfection of equipment and space.


Assuntos
/transmissão , Procedimentos Cirúrgicos Cardiovasculares , Infecção Hospitalar/transmissão , Procedimentos Cirúrgicos Eletivos , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Pandemias , Intervenção Coronária Percutânea , Adulto , Idoso , Idoso de 80 Anos ou mais , /prevenção & controle , Procedimentos Cirúrgicos Cardiovasculares/efeitos adversos , Infecção Hospitalar/prevenção & controle , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Masculino , Pessoa de Meia-Idade , Intervenção Coronária Percutânea/efeitos adversos , Complicações Pós-Operatórias , Medição de Risco
2.
Med Care ; 59(4): 288-294, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33605673

RESUMO

BACKGROUND: This qualitative research explored the lived experiences of patients who experienced postponement of elective cardiac and vascular surgery due to coronavirus disease 2019 (COVID-19). We know very little about patients during the novel coronavirus pandemic. Understanding the patient voice may play an important role in prioritization of postponed cases and triage moving forward. METHODS: Utilizing a hermeneutical phenomenological qualitative design, we interviewed 47 individuals who experienced a postponement of cardiac or vascular surgery due to the COVID-19 pandemic. Data were analyzed and informed by phenomenological research methods. RESULTS: Patients in our study described 3 key issues around their postponement of elective surgery. Patients described robust narratives about the meanings of their elective surgeries as the chance to "return to normal" and alleviate symptoms that impacted everyday life. Second, because of the meanings most of our patients ascribed to their surgeries, postponement often took a toll on how patients managed physical health and emotional well-being. Finally, paradoxically, many patients in our study were demonstrative that they would "rather die from a heart attack" than be exposed to the coronavirus. CONCLUSIONS: We identified several components of the patient experience, encompassing quality of life and other desired benefits of surgery, the risks of COVID, and difficulty reconciling the 2. Our study provides significant qualitative evidence to inform providers of important considerations when rescheduling the backlog of patients. The emotional and psychological distress that patients experienced due to postponement may also require additional considerations in postoperative recovery.


Assuntos
/prevenção & controle , Procedimentos Cirúrgicos Cardiovasculares/normas , Procedimentos Cirúrgicos Eletivos/normas , Angústia Psicológica , Tempo para o Tratamento , Adulto , Idoso , /psicologia , Procedimentos Cirúrgicos Cardiovasculares/psicologia , Procedimentos Cirúrgicos Eletivos/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Preferência do Paciente , Pesquisa Qualitativa , Fatores de Tempo , Triagem/normas
3.
Medicine (Baltimore) ; 100(4): e24478, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33530263

RESUMO

ABSTRACT: No guidelines have been established for the evaluation of swallowing function following extubation. The factors of bedside swallowing evaluations (BSEs) that are associated with the development of pneumonia have not been fully elucidated. This study aimed to retrospectively investigate the most appropriate measurements of BSEs for predicting pneumonia.The study subjects were 97 adults who underwent BSEs following cardiovascular surgery. Patients were divided into the pneumonia onset group (n = 21) and the non-onset group (n = 76). Patient characteristics, intraoperative characteristics, complications, BSE results, and postoperative progress were compared between the groups. BSEs were composed of consciousness level, modified water swallowing test (MWST) score, repetitive saliva swallowing test score, speech intelligibility score, and risk of dysphagia in the cardiac surgery score. Univariate and multivariate analyses with the BSE as the independent variable and pneumonia onset as the dependent variable were also performed to identify factors that predict pneumonia. For factors that became significant in univariate analysis, the incidence of pneumonia was shown using the Kaplan-Meier curve.No significant differences were found in patient characteristics, intraoperative characteristics, and complications between the 2 groups. The postoperative progress was significantly different between the 2 groups, the pneumonia-onset group had a significantly longer time until the start of oral intake and a significantly lower median value of Food Intake Level Scale at the time of discharge. According to univariate and multivariate analyses, MWST score was a significant factor for predicting the onset of pneumonia even after adjusting for patient characteristics and surgical factors, and the incidence of pneumonia increased approximately 3 times when the MWST score was 3 points or less.The MWST score after extubation in cardiovascular surgery was the strongest predictor of postoperative pneumonia in BSEs. Furthermore, the incidence of pneumonia increased approximately 3 times when the MWST score was 3 points or less. Predicting cases with a high risk of developing pneumonia allows nurses and attending physicians to monitor the progress carefully and take aggressive preventive measures.


Assuntos
Extubação/efeitos adversos , Transtornos de Deglutição/diagnóstico , Pneumonia/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Procedimentos Cirúrgicos Cardiovasculares/efeitos adversos , Estudos de Casos e Controles , Causalidade , Transtornos de Deglutição/etiologia , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Testes Imediatos , Estudos Retrospectivos , Fatores de Risco
4.
Pediatr Cardiol ; 42(1): 36-41, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33394107

RESUMO

In this review, we provide a brief description of recently published articles addressing topics relevant to pediatric cardiologists. Our hope is to provide a summary of the latest articles published recently in other journals in our field. The articles address (1) developing a risk score to predict adverse outcomes in patients with hypoplastic left heart syndrome using the national pediatric cardiology quality improvement collaborative, (2) outcomes of the Ross procedure in patients with a previous aortic valve surgery showing better outcomes in these patients compared to patients with the primary Ross procedure, (3) the initial experience with continuous flow ventricular assist devices in pediatric patients showing low mortality post implantation, (4) lower socioeconomic status is associated with worse long-term neurodevelopmental outcomes in patients with hypoplastic left heart syndrome, (5) QRS fragmentation is associated with higher incidence of appropriate shock after implantable cardioverter defibrillator implantation in repaired tetralogy of Fallot, (6) atrioventricular valve repair may have better outcomes if performed before the Fontan operation compared to after the Fontan operation.


Assuntos
Cardiologia , Procedimentos Cirúrgicos Cardiovasculares/métodos , Cardiopatias/terapia , Pediatria , Valva Aórtica/cirurgia , Criança , Feminino , Técnica de Fontan/métodos , Cardiopatias/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Coração Auxiliar , Humanos , Síndrome do Coração Esquerdo Hipoplásico/cirurgia , Masculino , Transtornos do Neurodesenvolvimento/epidemiologia , Publicações Periódicas como Assunto , Fatores de Risco , Fatores Socioeconômicos , Tetralogia de Fallot/cirurgia
5.
EuroIntervention ; 16(15): e1215-e1226, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33478939

RESUMO

Visual summary. Coronary interventional trials in 2020.


Assuntos
Procedimentos Cirúrgicos Cardiovasculares , Humanos
7.
EuroIntervention ; 16(14): 1177-1186, 2021 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-33416050

RESUMO

The rearrangement of healthcare services required to face the coronavirus disease 2019 (COVID-19) pandemic led to a drastic reduction in elective cardiac invasive procedures. We are already facing a "second wave" of infections and we might be dealing during the next months with a "third wave" and subsequently new waves. Therefore, during the different waves of the COVID-19 pandemic we have to face the problems of how to perform elective cardiac invasive procedures in non-COVID patients and which patients/procedures should be prioritised. In this context, the interplay between the pandemic stage, the availability of healthcare resources and the priority of specific cardiac disorders is crucial. Clear pathways for "hot" or presumed "hot" patients and "cold" patients are mandatory in each hospital. Depending on the local testing capacity and intensity of transmission in the area, healthcare facilities may test patients for SARS-CoV-2 infection before the interventional procedure, regardless of risk assessment for COVID-19. Pre-hospital testing should always be conducted in the presence of symptoms suggestive of SARS-CoV-2 infection. In cases of confirmed or suspected COVID-19 positive patients, full personal protective equipment using FFP 2/N95 masks, eye protection, gowning and gloves is indicated during cardiac interventions for healthcare workers. When patients have tested negative for COVID-19, medical masks may be sufficient. Indeed, individual patients should themselves wear medical masks during cardiac interventions and outpatient visits.


Assuntos
Procedimentos Cirúrgicos Cardiovasculares , Procedimentos Cirúrgicos Eletivos , Pandemias , Humanos , Máscaras , Equipamento de Proteção Individual
8.
Rev. SOBECC ; 25(4): 227-233, 21-12-2020.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1141400

RESUMO

Objetivo: Elaborar e realizar a validação de face e conteúdo da Escala de Avaliação do Conhecimento de Pacientes acerca da Cirurgia Cardíaca (EACCC). Método: Trata-se de um estudo metodológico, quantitativo, em que participaram 30 enfermeiros considerados expertos pelos critérios propostos por Fehring. Resultados: Os respondentes eram em sua maioria mulheres (24; 80,0%), com tempo médio de formação de 5,5±10,43 anos e tempo de experiência aproximado ao de formação (5,0±10,78). Não houve sugestão para alteração na forma de avaliar as respostas em cada item e pontuá-las, sendo realizadas alterações para a redação ou o conteúdo de itens, conforme sugestões. Conclusão: A versão final permaneceu com a mesma quantidade de itens da versão primeira. De forma geral, na avaliação dos juízes, a escala apresentou-se útil para o alcance do seu objetivo, estando pronta para a validação clínica.


Objective: To develop and perform the face and content validation of the Assessment Scale of Patient Knowledge about Cardiac surgery (Escala de Avaliação do Conhecimento de Pacientes acerca da Cirurgia Cardíaca - EACCC). Method: This is a methodological, quantitative study, in which 30 nurses considered experts according to the criteria proposed by Fehring participated. Results: The respondents were mostly women (24; 80.0%), with an average training time of 5.5±10.43 years and experience time approximately to the training (5.0±10.78). There was no suggestion to change the way to evaluate the responses in each item and score them, with changes being made to the wording or content of items, as suggested. Conclusion: The final version remained with the same number of items as the first version. In general, in the assessment of judges, the scale proved to be useful for achieving its objective, being ready for clinical validation.


Objetivo: Elaborar y realizar la validación de rostro y contenido de la Escala de Evaluación del Conocimiento de los Pacientes sobre Cirugía Cardíaca (EECCC). Método: Se trata de un estudio metodológico, cuantitativo, en el que participaron 30 enfermeras consideradas expertas según los criterios propuestos por Fehring. Resultados: Los encuestados fueron mayoritariamente mujeres (24; 80,0%), con un tiempo medio de formación de 5,5±10,43 años y un tiempo de experiencia similar al de la formación (5,0±10,78). No se sugirió cambiar la forma de evaluar las respuestas en cada ítem y calificarlas, con cambios en la redacción o el contenido de los ítems, como se sugirió. Conclusión: La versión final se mantuvo con el mismo número de ítems que la primera versión. En general, en la evaluación de los jueces, la Escala resultó útil para alcanzar su objetivo, estando lista para la validación clínica.


Assuntos
Humanos , Psicometria , Cirurgia Torácica , Enfermeiras e Enfermeiros , Cirurgia Geral , Procedimentos Cirúrgicos Cardiovasculares , Enfermagem Cardiovascular
9.
Medicine (Baltimore) ; 99(42): e22769, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33080746

RESUMO

BACKGROUND: To evaluate the effectiveness of neuromuscular electrical stimulation (NMES) in early rehabilitation of patients with postoperative complications after cardiovascular surgery. METHODS: 37 patients (25 men and 12 women) aged 45 to 70 years with postoperative complications after cardiovascular surgery were included in the study. Eighteen patients underwent NMES daily since postoperative day 3 until discharge in addition to standard rehabilitation program (NMES group), and 19 patients underwent standard rehabilitation program only (non-NMES group). The primary outcome was the knee extensors strength at discharge in NMES group and in control. Secondary outcomes were the handgrip strength, knee flexor strength, and cross-sectional area (CSA) of the quadriceps femoris in groups at discharge. RESULTS: Baseline characteristics were not different between the groups. Knee extensors strength at discharge was significantly higher in the NMES group (28.1 [23.8; 36.2] kg on the right and 27.45 [22.3; 33.1] kg on the left) than in the non-NMES group (22.3 [20.1; 27.1] and 22.5 [20.1; 25.9] kg, respectively; P < .001). Handgrip strength, knee flexor strength, quadriceps CSA, and 6 minute walk distance at discharge in the groups had no significant difference. CONCLUSIONS: This pilot study shows a beneficial effect of NMES on muscle strength in patients with complications after cardiovascular surgery. The use of NMES showed no effect on strength of non-stimulated muscle, quadriceps CSA, and distance of 6-minute walk test at discharge.Further blind randomized controlled trials should be performed with emphasis on the effectiveness of NEMS in increasing muscle strength and structure in these patients.


Assuntos
Procedimentos Cirúrgicos Cardiovasculares , Terapia por Estimulação Elétrica , Cuidados Pós-Operatórios , Complicações Pós-Operatórias , Sarcopenia/prevenção & controle , Idoso , Reabilitação Cardíaca , Feminino , Força da Mão , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular , Projetos Piloto , Sarcopenia/etiologia , Teste de Caminhada
10.
BMJ Open Qual ; 9(3)2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32988831

RESUMO

The COVID-19 pandemic has led to significant morbidity and mortality globally. As health systems grapple with caring for patients affected with COVID-19, cardiovascular procedures that are deemed 'elective' have been postponed. Guidelines concerning which cardiac procedures should be performed during the pandemic vary by specialty and geography in the USA. We propose a clinical heuristic to guide individual physicians and governing bodies in their decision making regarding which cardiac procedures should be performed during the COVID-19 pandemic using the behavioural economics concept of heuristics and ecological rationality.


Assuntos
Procedimentos Cirúrgicos Cardiovasculares/psicologia , Tomada de Decisão Clínica/métodos , Infecções por Coronavirus/prevenção & controle , Economia Comportamental , Procedimentos Cirúrgicos Eletivos/psicologia , Heurística , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus , Contraindicações de Procedimentos , Humanos , Estados Unidos
11.
Catheter Cardiovasc Interv ; 96(5): 1080-1086, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32882075

RESUMO

We aimed to examine factors impacting variability in cardiac procedural deferral during the COVID-19 pandemic and assess cardiologists' perspectives regarding its implications. Unprecedented cardiac procedural deferral was implemented nationwide during the COVID-19 pandemic. A web-based survey was administered by Society for Cardiovascular Angiography and Interventions and the American College of Cardiology Interventional Council to cardiac catheterization laboratory (CCL) directors and interventional cardiologists across the United States during the COVID-19 pandemic. Among 414 total responses, 48 states and 360 unique cardiac catheterization laboratories were represented, with mean inpatient COVID-19 burden 16.4 ± 21.9%. There was a spectrum of deferral by procedure type, varying by both severity of COVID-19 burden and procedural urgency (p < .001). Percutaneous coronary intervention volumes dropped by 55% (p < .0001) and transcatheter aortic valve replacement volumes dropped by 64% (p = .004), with cardiologists reporting an increase in late presenting ST-elevation myocardial infarctions and deaths among patients waiting for transcatheter aortic valve replacement. Almost 1/3 of catheterization laboratories had at least one interventionalist testing positive for COVID-19. Salary reductions did not influence procedural deferral or speed of reinstituting normal volumes. Pandemic preparedness improved significantly over time, with the most pressing current problems focused on inadequate testing and staff health risks. During the COVID-19 pandemic, cardiac procedural deferrals were associated with procedural urgency and severity of hospital COVID-19 burden. Yet patients did not appear to be similarly influenced, with cardiologists reporting increases in late presenting ST-elevation myocardial infarctions independent of local COVID-19 burden. The safety and importance of seeking healthcare during this pandemic deserves emphasis.


Assuntos
Betacoronavirus , Técnicas de Imagem Cardíaca , Procedimentos Cirúrgicos Cardiovasculares , Infecções por Coronavirus/prevenção & controle , Controle de Infecções/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Tempo para o Tratamento/organização & administração , Adulto , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Seleção de Pacientes , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Padrões de Prática Médica , Estados Unidos
12.
Arq Bras Cardiol ; 115(1): 111-126, 2020 07.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32813825

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic is a huge challenge to the health system because of the exponential increase in the number of individuals affected. The rational use of resources and correct and judicious indication for imaging exams and interventional procedures are necessary, prioritizing patient, healthcare personnel, and environmental safety. This review was aimed at guiding health professionals in safely and effectively performing imaging exams and interventional procedures.


Assuntos
Betacoronavirus , Doenças Cardiovasculares/cirurgia , Procedimentos Cirúrgicos Cardiovasculares/estatística & dados numéricos , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Guias de Prática Clínica como Assunto , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/diagnóstico por imagem , Doenças Transmissíveis Emergentes/epidemiologia , Infecções por Coronavirus/epidemiologia , Ecocardiografia , Humanos , Pandemias , Pneumonia Viral/epidemiologia
13.
Orv Hetil ; 161(31): 1271-1280, 2020 08.
Artigo em Húngaro | MEDLINE | ID: mdl-32750015

RESUMO

The issue of postoperative arrhythmias requiring pacemaker therapy is widely studied in the field of cardiac surgery and it is a complex perioperative problem. The aim of this paper is to summarize the relevant international guidelines and recommendations and to present our hospital's experience. We present the current, decisive recommendations and important studies, and present patients who underwent pacemaker implantation within one month after cardiac surgery between 01. 01. 2014 and 31. 12. 2018 in our hospital and compare them with the international findings. According to the international literature, the rate of permanent pacemaker implantation after cardiac surgery ranges from about 1.5% to 5%, and this rate seems to increase later. We have detailed information and many identified predictors about the development of conduction disturbances, but the current guidelines provide only weak recommendations. In the early perioperative period (1 month), pacemaker implantation was required in 15 cases (0.55%); in the course of long-term follow-up, 6 patients were still pacemaker-dependent. Perioperative arrhythmias are frequent and serious complications after cardiac surgery, prolong patient recovery time and put financial burden on the hospitals. The rate of need for a permanent pacemaker is low in our hospital, and in the late follow-up we can find only a small part of patients with pacemaker dependency. It would be necessary to start a prospective study and to develop a standardized protocol based on the information currently available. This would be a useful and authoritative help for the postoperative care in cardiac surgery. Orv Hetil. 2020; 161(31): 1271-1280.


Assuntos
Arritmias Cardíacas/prevenção & controle , Procedimentos Cirúrgicos Cardíacos/métodos , Procedimentos Cirúrgicos Cardiovasculares/métodos , Marca-Passo Artificial , Complicações Pós-Operatórias/prevenção & controle , Humanos , Período Pós-Operatório , Fatores de Risco , Resultado do Tratamento
16.
PLoS One ; 15(7): e0223343, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32649718

RESUMO

The quality of data in electronic healthcare databases is a critical component when used for research and health practice. The aim of the present study was to assess the data quality in the Paulista Cardiovascular Surgery Registry II (REPLICCAR II) using two different audit methods, direct and indirect. The REPLICCAR II database contains data from 9 hospitals in São Paulo State with over 700 variables for 2229 surgical patients. The data collection was performed in REDCap platform using trained data managers to abstract information. We directly audited a random sample (n = 107) of the data collected after 6 months and indirectly audited the entire sample after 1 year of data collection. The indirect audit was performed using the data management tools in REDCap platform. We computed a modified Aggregate Data Quality Score (ADQ) previously reported by Salati et al. (2015). The agreement between data elements was good for categorical data (Cohen κ = 0.7, 95%CI = 0.59-0.83). For continuous data, the intraclass coefficient (ICC) for only 2 out of 15 continuous variables had an ICC < 0.9. In the indirect audit, 77% of the selected variables (n = 23) had a good ADQ score for completeness and accuracy. Data entry in the REPLICCAR II database proved to be satisfactory and showed competence and reliable data for research in cardiovascular surgery in Brazil.


Assuntos
Bases de Dados Factuais , Brasil , Procedimentos Cirúrgicos Cardiovasculares , Confiabilidade dos Dados , Humanos , Sistema de Registros
18.
J Card Surg ; 35(10): 2768-2772, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32668048

RESUMO

BACKGROUND: The coronavirus disease (COVID-19) has affected a large population across the world. Patients with cardiovascular disease have increased morbidity and mortality due to coronavirus disease. The burden over the health care system has to be reduced in this global pandemic to provide optimal care of patients with COVID-19, as well not compromising those who are in need of emergent cardiovascular care. METHODS: There is a very limited data published defining which cardiovascular procedures are to be performed or to be deferred in the COVID-19 pandemic. In this article, we have reviewed a few published guidelines regarding cardiovascular surgery in COVID-19 pandemics. CONCLUSION: After reviewing a few available guidelines regarding cardiovascular surgery in COVID-19, we conclude to perform only those surgeries which cannot be deferred to a certain period of time, to reduce the burden of the health care system of the country, provide optimal care to patients with COVID-19, and to protect health care workers and cardiovascular patients from COVID-19.


Assuntos
Betacoronavirus , Doenças Cardiovasculares/cirurgia , Procedimentos Cirúrgicos Cardiovasculares/normas , Infecções por Coronavirus/epidemiologia , Transmissão de Doença Infecciosa/prevenção & controle , Procedimentos Cirúrgicos Eletivos/métodos , Pandemias , Pneumonia Viral/epidemiologia , Doenças Cardiovasculares/epidemiologia , Comorbidade , Infecções por Coronavirus/transmissão , Humanos , Pneumonia Viral/transmissão
19.
Enferm. foco (Brasília) ; 11(2): 154-159, jul. 2020. graf, tab
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1104412

RESUMO

Objetivo: traçar o perfil dos enfermeiros perfusionistas brasileiros atuantes no mercado de trabalho. Métodos: trata-se de um estudo observacional com delineamento transversal. Foram obtidos dados de perfil sócio demográfico e profissional dos perfusionistas em situação ativa no Brasil através do preenchimento de um questionário eletrônico. A amostra contemplou 70 enfermeiros perfusionistas. Resultados: a maioria dos profissionais é do sexo feminino (44%), possui 38,3±8,62 anos. A formação complementar demonstra um período de transição e aperfeiçoamento nesta especialidade: 84,2% destes possuem pós-graduação. Conclusão: o perfil profissional dos enfermeiros perfusionistas está em franca evolução em termos de qualificação e, nesse enfoque, torna-se necessário o conhecimento da especialidade para o delineamento de novas ações e inserção profissional em diferentes cenários da tecnologia extracorpórea. (AU)


Objective: to profile the Brazilian perfusionist nurses working in the labor market. Methods: This is an observational study with cross-sectional design. Data on socio-demographic and professional profile of perfusionists in active situation in Brazil were obtained by completing an electronic questionnaire. The sample included 70 perfusionist nurses. Results: most professionals are female (44%), 38.3 ± 8.62 years old. Complementary education demonstrates a period of transition and improvement in this specialty: 84.2% of these have postgraduate degrees. Conclusion: the professional profile of perfusionist nurses is clearly evolving in terms of qualification and, in this approach, it is necessary to know the specialty to delineate new actions and professional insertion in different scenarios of extracorporeal technology. (AU)


Objetivo: perfilar las enfermeras perfusionistas brasileñas que trabajan en el mercado laboral. Métodos: Este es un estudio observacional con diseño transversal. Los datos sobre el perfil sociodemográfico y profesional de perfusionistas en situación activa en Brasil se obtuvieron completando un cuestionario electrónico. La muestra incluyó 70 enfermeras perfusionistas. Resultados: la mayoría de los profesionales son mujeres (44%), 38.3 ± 8.62 años. La educación complementaria demuestra un período de transición y mejora en esta especialidad: 84,2% de ellos tienen títulos de posgrado. Conclusión: el perfil profesional de las enfermeras perfusionistas está evolucionando claramente en términos de calificación y, en este enfoque, es necesario conocer la especialidad para delinear nuevas acciones e inserción profesional en diferentes escenarios de tecnología extracorpórea. (AU)


Assuntos
Circulação Extracorpórea , Procedimentos Cirúrgicos Cardiovasculares , Enfermagem , Enfermeiras e Enfermeiros
20.
PLos ONE ; 15(7): 1-13, July., 2020. tab., graf.
Artigo em Inglês | Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1122314

RESUMO

The quality of data in electronic healthcare databases is a critical component when used for research and health practice. The aim of the present study was to assess the data quality in the Paulista Cardiovascular Surgery Registry II (REPLICCAR II) using two different audit methods, direct and indirect. The REPLICCAR II database contains data from 9 hospitals in São Paulo State with over 700 variables for 2229 surgical patients. The data collection was performed in REDCap platform using trained data managers to abstract information. We directly audited a random sample (n = 107) of the data collected after 6 months and indirectly audited the entire sample after 1 year of data collection. The indirect audit was performed using the data management tools in REDCap platform. We computed a modified Aggregate Data Quality Score (ADQ) previously reported by Salati et al. (2015). The agreement between data elements was good for categorical data (Cohen κ = 0.7, 95%CI = 0.59-0.83). For continuous data, the intraclass coefficient (ICC) for only 2 out of 15 continuous variables had an ICC < 0.9. In the indirect audit, 77% of the selected variables (n = 23) had a good ADQ score for completeness and accuracy. Data entry in the REPLICCAR II database proved to be satisfactory and showed competence and reliable data for research in cardiovascular surgery in Brazil.


Assuntos
Humanos , Procedimentos Cirúrgicos Cardiovasculares , Confiabilidade dos Dados , Sistema de Registros , Bases de Dados Factuais
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