Analysis of the Use of Extracorporeal Circulation on the In-Hospital Outcomes of Dialytic Patients Who Underwent Myocardial Revascularization Surgery
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2016 |
| Outros Autores: | , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng por |
| Título da fonte: | Repositório Institucional da UNIFESP |
| Texto Completo: | http://dx.doi.org/10.5935/abc.20160180 https://repositorio.unifesp.br/handle/11600/56591 |
Resumo: | Background: Myocardial revascularization surgery is the best treatment for dyalitic patients with multivessel coronary disease. However, the procedure still has high morbidity and mortality. The use of extracorporeal circulation (ECC) can have a negative impact on the in-hospital outcomes of these patients. Objectives: To evaluate the differences between the techniques with ECC and without ECC during the in-hospital course of dialytic patients who underwent surgical myocardial revascularization. Methods: Unicentric study on 102 consecutive, unselected dialytic patients, who underwent myocardial revascularization surgery in a tertiary university hospital from 2007 to 2014. Results: Sixty-three patients underwent surgery with ECC and 39 without ECC. A high prevalence of cardiovascular risk factors was found in both groups, without statistically significant difference between them. The group "without ECC" had greater number of revascularizations (2.4 vs. 1.7 |
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Analysis of the Use of Extracorporeal Circulation on the In-Hospital Outcomes of Dialytic Patients Who Underwent Myocardial Revascularization SurgeryAnálise do Uso da Circulação Extracorpórea na Evolução Intra-Hospitalar de Pacientes Dialíticos Submetidos à Revascularização Cirúrgica do MiocárdioMyocardial RevascularizationExtracorporeal Circulation / utilizationClinical EvolutionDialysisHospitalizationRevascularização MiocárdicaCirculação Extracorpórea / utilizaçãoEvolução ClínicaPacientes InternadosDiáliseHospitalizaçãoBackground: Myocardial revascularization surgery is the best treatment for dyalitic patients with multivessel coronary disease. However, the procedure still has high morbidity and mortality. The use of extracorporeal circulation (ECC) can have a negative impact on the in-hospital outcomes of these patients. Objectives: To evaluate the differences between the techniques with ECC and without ECC during the in-hospital course of dialytic patients who underwent surgical myocardial revascularization. Methods: Unicentric study on 102 consecutive, unselected dialytic patients, who underwent myocardial revascularization surgery in a tertiary university hospital from 2007 to 2014. Results: Sixty-three patients underwent surgery with ECC and 39 without ECC. A high prevalence of cardiovascular risk factors was found in both groups, without statistically significant difference between them. The group "without ECC" had greater number of revascularizations (2.4 vs. 1.7p < 0.0001) and increased need for blood components (77.7% vs. 25.6%p < 0.0001) and inotropic support (82.5% vs 35.8%p < 0.0001). In the postoperative course, the group "without ECC" required less vasoactive drugs, (61.5% vs. 82.5%p = 0.0340) and shorter time of mechanical ventilation (13.0 hours vs. 36,3 hours, p = 0.0217), had higher extubation rates in the operating room (58.9% vs. 23.8%, p = 0.0006), lower infection rates (7.6% vs. 28.5%p = 0.0120), and shorter ICU stay (5.2 days vs. 8.1 daysp = 0.0054) as compared with the group with ECC surgery. No difference in mortality was found between the groups. Conclusion: Myocardial revascularization with ECC in patients on dialysis resulted in higher morbidity in the perioperative period in comparison with the procedure without ECC, with no difference in mortality though.Fundamento: A revascularização cirúrgica do miocárdio é o melhor tratamento para o paciente dialítico com doença coronariana multiarterial. Contudo, o procedimento ainda apresenta elevada morbimortalidade. O uso da circulação extracorpórea (CEC) pode impactar de maneira negativa na evolução intra-hospitalar desses pacientes. Objetivos: Avaliar a diferença entre as técnicas com ou sem CEC na evolução intra-hospitalar de pacientes dialíticos submetidos a cirurgia de revascularização do miocárdio. Métodos: Estudo unicêntrico de 102 pacientes dialíticos consecutivos e não selecionados, submetidos à revascularização cirúrgica do miocárdio em um hospital terciário universitário no período de 2007 a 2014. Resultados: 63 pacientes foram operados com CEC e 39 sem o uso de CEC. Foi observada alta prevalência de fatores de risco cardiovascular em ambos grupos, porém sem diferença estatisticamente significante entre eles. O grupo "com CEC" apresentou maior número de coronárias revascularizadas (2,4 vs 1,7; p <0,0001), maior necessidade de hemocomponentes (77,7% vs 25,6%; p <0,0001) e apoio inotrópico (82,5% vs 35,8%; p <0,0001). Na evolução pós-operatória, o grupo "sem CEC" apresentou menor necessidade de drogas vasoativas (61,5% vs 82,5%; p = 0,0340), maior taxa de extubação em sala cirúrgica (58,9% vs 23,8%, p = 0,0006), menor tempo de ventilação mecânica (13,0 horas vs 36,3 horas, p = 0,0217), menor taxa de infecções (7,6% vs 28,5%; p = 0,0120) e menor tempo de internação em UTI (5,2 dias vs 8,1 dias; p = 0,0054) em comparação ao grupo "com CEC". Não houve diferença de mortalidade entre os grupos. Conclusão: O uso da CEC na revascularização do miocárdio em pacientes dialíticos resultou em maior morbidade no período perioperatório em comparação ao procedimento realizado sem CEC, contudo, sem diferença de mortalidade.Univ Fed Sao Paulo, Hosp Rim & Hipertensao, Escola Paulista Med UNIFESP EPM, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, Sao Paulo, SP, BrazilHospital do Rim e Hipertensão - Universidade Federal de São Paulo - Escola Paulista de Medicina (UNIFESP-EPM) - BrazilUniversidade Federal de São Paulo (UNIFESP), São Paulo, SP - BrazilWeb of ScienceArquivos Brasileiros Cardiologia2020-07-31T12:47:06Z2020-07-31T12:47:06Z2016info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion518-522application/pdfapplication/pdfhttp://dx.doi.org/10.5935/abc.20160180Arquivos Brasileiros De Cardiologia. Rio De Janeiro, v. 107, n. 6, p. 518-522, 2016.10.5935/abc.20160180S0066-782X2016004500518-en.pdfS0066-782X2016004500518-pt.pdf0066-782XS0066-782X2016004500518https://repositorio.unifesp.br/handle/11600/56591WOS:000392850100003engporArquivos Brasileiros De CardiologiaRio De Janeiroinfo:eu-repo/semantics/openAccessMiranda, Matheus [UNIFESP]Branco, João Nelson Rodrigues [UNIFESP]Vargas, Guilherme Flora [UNIFESP]Hossne Junior, Nelson Americo [UNIFESP]Yoshimoto, Michele Costa [UNIFESP]Fonseca, José Honório de Almeida Palma da [UNIFESP]Pestana, Jose Osmar Medina [UNIFESP]Buffolo, Enio [UNIFESP]reponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-08-11T12:35:01Zoai:repositorio.unifesp.br/:11600/56591Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-08-11T12:35:01Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
| dc.title.none.fl_str_mv |
Analysis of the Use of Extracorporeal Circulation on the In-Hospital Outcomes of Dialytic Patients Who Underwent Myocardial Revascularization Surgery Análise do Uso da Circulação Extracorpórea na Evolução Intra-Hospitalar de Pacientes Dialíticos Submetidos à Revascularização Cirúrgica do Miocárdio |
| title |
Analysis of the Use of Extracorporeal Circulation on the In-Hospital Outcomes of Dialytic Patients Who Underwent Myocardial Revascularization Surgery |
| spellingShingle |
Analysis of the Use of Extracorporeal Circulation on the In-Hospital Outcomes of Dialytic Patients Who Underwent Myocardial Revascularization Surgery Miranda, Matheus [UNIFESP] Myocardial Revascularization Extracorporeal Circulation / utilization Clinical Evolution Dialysis Hospitalization Revascularização Miocárdica Circulação Extracorpórea / utilização Evolução Clínica Pacientes Internados Diálise Hospitalização |
| title_short |
Analysis of the Use of Extracorporeal Circulation on the In-Hospital Outcomes of Dialytic Patients Who Underwent Myocardial Revascularization Surgery |
| title_full |
Analysis of the Use of Extracorporeal Circulation on the In-Hospital Outcomes of Dialytic Patients Who Underwent Myocardial Revascularization Surgery |
| title_fullStr |
Analysis of the Use of Extracorporeal Circulation on the In-Hospital Outcomes of Dialytic Patients Who Underwent Myocardial Revascularization Surgery |
| title_full_unstemmed |
Analysis of the Use of Extracorporeal Circulation on the In-Hospital Outcomes of Dialytic Patients Who Underwent Myocardial Revascularization Surgery |
| title_sort |
Analysis of the Use of Extracorporeal Circulation on the In-Hospital Outcomes of Dialytic Patients Who Underwent Myocardial Revascularization Surgery |
| author |
Miranda, Matheus [UNIFESP] |
| author_facet |
Miranda, Matheus [UNIFESP] Branco, João Nelson Rodrigues [UNIFESP] Vargas, Guilherme Flora [UNIFESP] Hossne Junior, Nelson Americo [UNIFESP] Yoshimoto, Michele Costa [UNIFESP] Fonseca, José Honório de Almeida Palma da [UNIFESP] Pestana, Jose Osmar Medina [UNIFESP] Buffolo, Enio [UNIFESP] |
| author_role |
author |
| author2 |
Branco, João Nelson Rodrigues [UNIFESP] Vargas, Guilherme Flora [UNIFESP] Hossne Junior, Nelson Americo [UNIFESP] Yoshimoto, Michele Costa [UNIFESP] Fonseca, José Honório de Almeida Palma da [UNIFESP] Pestana, Jose Osmar Medina [UNIFESP] Buffolo, Enio [UNIFESP] |
| author2_role |
author author author author author author author |
| dc.contributor.author.fl_str_mv |
Miranda, Matheus [UNIFESP] Branco, João Nelson Rodrigues [UNIFESP] Vargas, Guilherme Flora [UNIFESP] Hossne Junior, Nelson Americo [UNIFESP] Yoshimoto, Michele Costa [UNIFESP] Fonseca, José Honório de Almeida Palma da [UNIFESP] Pestana, Jose Osmar Medina [UNIFESP] Buffolo, Enio [UNIFESP] |
| dc.subject.por.fl_str_mv |
Myocardial Revascularization Extracorporeal Circulation / utilization Clinical Evolution Dialysis Hospitalization Revascularização Miocárdica Circulação Extracorpórea / utilização Evolução Clínica Pacientes Internados Diálise Hospitalização |
| topic |
Myocardial Revascularization Extracorporeal Circulation / utilization Clinical Evolution Dialysis Hospitalization Revascularização Miocárdica Circulação Extracorpórea / utilização Evolução Clínica Pacientes Internados Diálise Hospitalização |
| description |
Background: Myocardial revascularization surgery is the best treatment for dyalitic patients with multivessel coronary disease. However, the procedure still has high morbidity and mortality. The use of extracorporeal circulation (ECC) can have a negative impact on the in-hospital outcomes of these patients. Objectives: To evaluate the differences between the techniques with ECC and without ECC during the in-hospital course of dialytic patients who underwent surgical myocardial revascularization. Methods: Unicentric study on 102 consecutive, unselected dialytic patients, who underwent myocardial revascularization surgery in a tertiary university hospital from 2007 to 2014. Results: Sixty-three patients underwent surgery with ECC and 39 without ECC. A high prevalence of cardiovascular risk factors was found in both groups, without statistically significant difference between them. The group "without ECC" had greater number of revascularizations (2.4 vs. 1.7 |
| publishDate |
2016 |
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2016 2020-07-31T12:47:06Z 2020-07-31T12:47:06Z |
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info:eu-repo/semantics/article |
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info:eu-repo/semantics/publishedVersion |
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article |
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publishedVersion |
| dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.5935/abc.20160180 Arquivos Brasileiros De Cardiologia. Rio De Janeiro, v. 107, n. 6, p. 518-522, 2016. 10.5935/abc.20160180 S0066-782X2016004500518-en.pdf S0066-782X2016004500518-pt.pdf 0066-782X S0066-782X2016004500518 https://repositorio.unifesp.br/handle/11600/56591 WOS:000392850100003 |
| url |
http://dx.doi.org/10.5935/abc.20160180 https://repositorio.unifesp.br/handle/11600/56591 |
| identifier_str_mv |
Arquivos Brasileiros De Cardiologia. Rio De Janeiro, v. 107, n. 6, p. 518-522, 2016. 10.5935/abc.20160180 S0066-782X2016004500518-en.pdf S0066-782X2016004500518-pt.pdf 0066-782X S0066-782X2016004500518 WOS:000392850100003 |
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eng por |
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eng por |
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Arquivos Brasileiros De Cardiologia |
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info:eu-repo/semantics/openAccess |
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openAccess |
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518-522 application/pdf application/pdf |
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Rio De Janeiro |
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Arquivos Brasileiros Cardiologia |
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Arquivos Brasileiros Cardiologia |
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reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
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Universidade Federal de São Paulo (UNIFESP) |
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UNIFESP |
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UNIFESP |
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Repositório Institucional da UNIFESP |
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Repositório Institucional da UNIFESP |
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Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
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biblioteca.csp@unifesp.br |
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