Avaliação da função ventricular pelo ecocardiograma no pós operatório imediato de pacientes submetidos a cirurgia cardíaca pediátrica

• Autor(a) principal: Oliveira Júnior, Francisco Sávio de
• Data de Publicação: 2013
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tede/3898
• topic: Cirurgia cardíaca pediátrica; Ecocardiograma; Função ventricular; Pediatric cardiac surgery; Echocardiography; Ventricular function; CIENCIAS DA SAUDE

The ventricular dysfunction is one of the most common complications and one of the greatest challenges in conducting of the patient undergoing pediatric cardiac surgery. Understanding the factors that trigger the development of ventricular function and dysfunction postoperatively is critical to the proper management. The aim of this study was to evaluate ventricular systolic function by echocardiography over the first 48 hours of patients undergoing cardiac surgery for biventricular correction. We evaluated 34 patients with a mean age of 18.6 ± 15.6 months, undergoing cardiac surgery with cardiopulmonary bypass. Clinical analysis performed over the 48 hours, incluinding the measurement of NT-pro-BNP, troponin and serum lactate in the first 2 hours, were beyond the quantification of inotropic score and CPB time. Echocardiography was performed at 2 hours, 12 hours, 24 hours and 48 hours after admission to the ICU and the pediatric parameters analyzed were LV ejection fraction, the myocardial performance index of LV and RV tissue Doppler systolic velocity of the lateral wall LV and RV (S wave) and cardiac index. The sequential evaluation of left ventricular systolic function in the first 48 hours after surgery showed no variation, was observed only increase in ejection fraction of the left ventricle (P = 0.008), and variation is limited to the comparison between measures at 24 and 48 hours (P Bonferroni = 0.04). Analysis of right ventricular function did not vary over the 48 hours. Despite the failure to detect the change in the trend function has been observed that the MPI`s RV and LV remained changed along the 48hs.There was no correlation between the myocardial performance index of the right ventricle and the left ventricle with a time of extracorporeal circulation. There was no correlation between the measures of surgical stress and echocardiographic parameters measured two hours after surgery. The echocardiographic variables that assessed right and left ventricular function were within the normal range and showed no significant variation over the first 48 hours after cardiac surgery.