O impacto do tempo de circulação extracorpórea no pós-operatório imediato de revascularização do miocárdio

• Autor(a) principal: Freitas, Fabiana Góes Barbosa de
• Data de Publicação: 2021
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UFPB
• Texto Completo: https://repositorio.ufpb.br/jspui/handle/123456789/22110
• topic: Cirurgia cardíaca; Hemoglobina; Glicemia; Cardiac surgery; Hemoglobin; Glycemia; CNPQ::CIENCIAS BIOLOGICAS::FISIOLOGIA

Cardiac surgery is a important intervention to decrease morbidity and mortality due to cardiovascular diseases that have low probability of cure, with myocardial revascularization being the most frequently surgery. This procedure aims to reduce symptoms caused by obstruction of coronary arteries, prolonging the life of the individual. The use of cardiopulmonary bypass is been the “gold standard” for these surgeries however, it can trigger deleterious effects to the body, such as: the systemic inflammatory response, myocardial depression, coagulopathies, hemodynamic instability and pulmonary dysfunction. Thus, the objective of this study was to evaluate cardiopulmonary bypass impact into profile of hemodynamic and biomarkers in patients undergoing myocardial revascularization surgery in different times. Were analyzes 153 patients that underwent myocardial revascularization surgery in a hospital in João Pessoa, were after being divide into 3 groups according to the cardiopulmonary bypass time: Group 0-60 (from 0 to 60 minutes), group 61-90 (from 61 to 90 minutes) and group 90+ (above 90 minutes). We verified the variables that were taken during the immediate postoperative period, such as: mean arterial pressure, heart rate, leukocytes, hemoglobin, glycemia, creatinine, extubation time, arterial blood gas analysis and central venous pressure. We observed that the profile of patients is predominantly male, mean of ages 63,06 ± 9,41 years, high blood pressure and elderly. Based on our data, there was not correlation between CPB time and hemodynamic parameters like heart rate and pressures. The same was found with ventilatory and oxygenation parameters. A negative correlation was found between CPB time and HCO3 (r=-0,2576; p=0,0013) and base excess (r=-0,2940; p=0,0002). None correlation with leukocytes were find. Still, was observed differences in the levels of hemoglobin ((r=-0,3608; p<0,0001) and glycemia (r=0,1714; p=0,0400) between group 1 and 3. Regarding extubation time, it was observed that individuals with shorter cardiopulmonary bypass time presented extubation more frequently in the operating room than the others. The cardiopulmonary bypass time had impact into acid-base balance, blood glucose, hemoglobin and extubation time of patients undergoing myocardial revascularization surgery, directly influencing the homeostasis of these individuals. Although the duration of the use of cardiopulmonary bypass is not the only one responsible for the appearance of complications, the data obtained so far demonstrate the importance of a multidisciplinary team in the immediate postoperative period, such as doctors, nurses and physicaltherapists, in order to reduce the chances of complications and their effects on the morbidity and mortality of these patients.