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1.
Rev. bras. ginecol. obstet ; 43(12): 961-967, Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1357088

ABSTRACT

Abstract Objective To evaluate the differences between bladder emptying options (permanent catheterization and intermittent bladder emptying/spontaneous urination) regarding the effects on labor length, need of operative vaginal deliveries, and cesarean section rate. Data Sources The search was conducted in MEDLINE, Scopus, Web of Science, and The Cochrane Central Register of Controlled Trials databases. Selection of Studies The survey returned 964 studies. A total of 719 studies were evaluated by title and abstract, of which 4 were selected for inclusion. Data Collection All references were inserted in the Rayyan QCRI tool (Rayyan Systems Inc., Cambridge, MA, USA). The full text of the selected articles was obtained so we could later decide whether or not to include them in this systematic review. Data Synthesis No differences were found in the number of instrumented deliveries or in cesarean section rate between groups. Conclusions After evaluating the studies performed on the topic, we concluded that there is no clear advantage to either method, although continuous catheterization was associated with a greater occurrence of eutocic births. In the remaining outcomes, there were no differences between catheterization types.


Resumo Objetivo Avaliar as diferenças entre as opções de esvaziamento vesical (cateterismo permanente e esvaziamento vesical intermitente/micção espontânea) em relação aos efeitos na duração do trabalho de parto, necessidade de partos vaginais operatórios e taxa de cesárea. Fontes de Dados A pesquisa foi realizada nas bases de dados MEDLINE, Scopus, Web of Science, e The Cochrane Central Register of Controlled Trials. Seleção de Estudos A pesquisa retornou 964 estudos. Um total de 719 estudos foram avaliados por título e resumo, dos quais 4 foram selecionados para inclusão. Coleta de Dados Todas as referências foram inseridas na ferramenta Rayyan QCRI (Rayyan Systems Inc., Cambridge, MA, EUA). O texto completo dos artigos selecionados foi obtido para posterior decisão de incluí-los nesta revisão sistemática. Síntese dos Dados Não foram encontradas diferenças no número de partos instrumentados ou na taxa de cesariana entre os grupos. Conclusões Após avaliação dos estudos realizados sobre o tema, concluímos que não hávantagem clara de qualquer um dos métodos, embora o cateterismo contínuo tenha sido associado à maior ocorrência de partos eutócicos. Nos demais desfechos, não houve diferenças entre os tipos de cateterismo.


Subject(s)
Humans , Female , Pregnancy , Labor, Obstetric , Cesarean Section , Catheterization , Delivery, Obstetric , Parturition
2.
Rev. colomb. anestesiol ; 49(3): e202, July-Sept. 2021. graf
Article in English | LILACS, COLNAL | ID: biblio-1280178

ABSTRACT

Abstract Introduction: In-line positioning of an ultrasound image provides higher success rates and less time to completion for radial arterial cannulation. But preferable size and distance of ultrasound display has not been previously discussed. Objective: To assess the ideal visual distance and display size when using a smart phone or tablet as the ultrasound image display. Methods: Four smart phones or tablets were used as ultrasound displays in six different configurations in a simulated radial artery puncture. In a questionnaire, 116 anaesthesiologists working in Ibaraki Prefecture, Japan, were asked which of the six configurations was preferable for radial artery cannulation. Results: Sixty anaesthesiologists answered the questionnaire. About half (53%) preferred the smaller display (4- or 5.5-inch) fixed at a distance of 30 to 40 cm, and most of the rest (44%) preferred the larger display (7.9- or 9.7-inch) placed posterior to the probe with a visual distance of 45 to 60 cm. Conclusions: Among the anaesthesiologists, the preferable size and visual distance for ultrasound-guided radial artery cannulation varied using a smart phone or tablet for in-line display.


Resumen Introducción: El posicionamiento en línea con una imagen ecográfica permite mayores tasas de éxito y reduce el tiempo para realizar la canalización de la arteria radial. Sin embargo, no se ha hablado sobre cuál es el tamaño y la distancia preferibles para la imagen en pantalla. Objetivo: Evaluar la distancia visual y el tamaño de la imagen en pantalla cuando se utiliza un teléfono inteligente o una tableta para visualizar la imagen ecográfica. Métodos: Se utilizaron cuatro teléfonos inteligentes o tabletas como pantalla para visualizar las imágenes ecográficas en seis configuraciones distintas, en una simulación de la canalización de la arteria radial. Mediante un cuestionario se preguntó a 116 anestesiólogos que trabajan para la Prefectura de Ibaraki, Japón, cuál de las seis configuraciones era preferible para la canalización de la arteria radial. Resultados: Sesenta anestesiólogos respondieron el cuestionario. Aproximadamente la mitad (53%) prefirieron la imagen más pequeña (4 o 5,5 pulgadas), fija a una distancia de 30 a 40 cm, y la mayoría de los otros (44%) prefirieron la imagen más grande (7,9- o 9,7 pulgadas), colocada en la parte posterior al transductor, con una distancia visual de 45 a 60 cm. Conclusiones: Entre los anestesiólogos, el tamaño preferido y la distancia visual para la canalización de la arteria radial guiada por ecografía, varió utilizando un teléfono inteligente o una tableta para su visualización en línea.


Subject(s)
Humans , Catheterization , Ultrasonography , Radial Artery , Anesthesiologists , Punctures , Probe , Smartphone , Methods
3.
Cienc. Salud (St. Domingo) ; 5(2): [69-76], Ene-Abr. 2021. tab
Article in Spanish | LILACS | ID: biblio-1363016

ABSTRACT

Introducción: el síndrome coronario agudo (SCA) es una serie de signos y síntomas que se refieren a isquemia miocárdica repentina. Estas condiciones clínicas son Síndrome Coronario agudo sin Elevación del Segmento ST (SCASEST) y Síndrome Coronario Agudo con Elevación del Segmento ST (SCACEST). A nivel mundial hay hallazgos controversiales con respecto a la diferencia de presentación de SCA en hombres y mujeres. Objetivo: determinar las diferencias en presentación del síndrome coronario agudo según el género en República Dominicana. Métodos: en este estudio observacional retrospectivo unicéntrico, 3,548 pacientes con SCA llevados al laboratorio de cateterismo fueron observados durante el período de agosto de 2016 a septiembre de 2019. Resultados: la edad promedio de presentación fue mayor en las mujeres, con una media de 63 años (DE ± 12.2). El SCACEST fue más frecuente en hombres (69.35 %) y la Angina Inestable en mujeres (50.14 %, p <0.0001). Angiográficamente, la enfermedad coronaria multivascular fue más común en hombres y la angiografía coronaria normal en mujeres (41.30 % y 35.37 %, p < 0.0001). Conclusión: dentro de la población dominicana, la mujer tiende a ser mayor al momento de presentación de SCA, con menor tendencia a someterse a intervención coronaria terapéutica.


Introduction: Acute Coronary Syndrome (ACS) is a series of signs and symptoms referring to sudden myocardial ischemia. These clinical conditions are: Non-ST-Acute Coronary Syndromes (NST-ACS) and ST-segment Elevation Myocardial Infarction (STEMI). Globally there are controversial findings regarding the difference in SCA presentation in both men and women. Objective: Determine differences in presentation of acute coronary syndrome by gender in the Dominican Republic. Methods: In this retrospective single-centered observational study 3,548 patients with ACS taken to the catheterization laboratory underwent observation, during the time frame of August 2016 to September 2019. Results: The average age of presentation was higher in females, with a mean of 63 years old (SD ± 12.2). STEMI was greater in males (69.35%) and females presented more with UA (50.14%, p<0.0001). Angiography findings showed that multi-vascular coronary artery disease was more common in males and normal coronary angiography more frequent in females (41.30% and 35.37%, p<0.0001). Conclusion: Within the Dominican population, females tend to be older at the time of appearance of ACS with a lower tendency of undergoing coronary intervention.


Subject(s)
Catheterization , Non-ST Elevated Myocardial Infarction , ST Elevation Myocardial Infarction , Women , Dominican Republic , Men
4.
REME rev. min. enferm ; 25: e1370, 2021. tab, graf
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1340527

ABSTRACT

RESUMO Objetivo: construir e validar o conteúdo da cartilha "É hora de pegar a minha veia: o que eu faço?", juntamente com juízes especialistas na área da Pediatria, para o preparo de crianças com necessidade de cateterização intravenosa periférica. Método: trata-se de um estudo metodológico do tipo validação de conteúdo, desenvolvido conforme o checklist COSMIM, realizado no período de fevereiro de 2015 a fevereiro de 2017, em quatro etapas: diagnóstico situacional, levantamento bibliográfico, seleção e sumarização do conteúdo, elaboração da cartilha e sua validação. Participaram do estudo 11 juízas especialistas na área de Pediatria. Para o processo de validação utilizou-se a técnica Delphi. Consideraram-se como índice de validação de conteúdo desejável os valores iguais ou superiores a 0,80. Resultados: a cartilha obteve índices satisfatórios nas categorias conteúdo, linguagem, ilustração, layout, motivação, cultura e aplicabilidade, sendo validada na segunda rodada com índice de validação de conteúdo global de 0,93. Conclusão: o objetivo do estudo foi alcançado, sendo a cartilha construída e validada pelos juízes especialistas, portanto, pode ser um recurso tecnológico de promoção do cuidado para crianças com necessidade de cateterização intravenosa periférica, configurando-se em uma medida de segurança do paciente.


RESUMEN Objetivo: construir y validar el contenido del folleto "Es hora de tomarme la vena: ¿qué hago?", Junto a jueces expertos en el área de Pediatría, para la preparación de niños con necesidad de cateterismo intravenoso periférico. Método: se trata de un estudio metodológico del tipo de validación de contenido, desarrollado según la lista de verificación COSMIM, realizado de febrero de 2015 a febrero de 2017, en cuatro etapas: diagnóstico situacional, relevamiento bibliográfico, selección y resumen del contenido, elaboración del folleto y su validación. En el estudio participaron once jueces especializados en Pediatría. Para el proceso de validación se utilizó la técnica Delphi. Se consideraron como índice de validación de contenido los valores iguales o superiores a 0,80. Resultados: el folleto obtuvo índices satisfactorios en las categorías contenido, lenguaje, ilustración, maquetación, motivación, cultura y aplicabilidad, siendo validado en la segunda ronda con un índice de validación de contenido global de 0,93. Conclusión: se logró el objetivo del estudio, y el folleto fue construido y validado por los jueces expertos, por lo tanto, puede ser un recurso tecnológico para promover el cuidado de niños con necesidad de cateterismo intravenoso periférico, configurándose como una medida de seguridad del paciente.


ABSTRACT Objective: to build and validate the contents of the booklet "It is time to get my vein: what do I do?", Together with expert judges in the field of Pediatrics, for the preparation of children in need of peripheral intravenous catheterization. Method: this is a methodological study of the content validation type, developed according to the COSMIM checklist, carried out from February 2015 to February 2017, in four stages: situational diagnosis, bibliographic survey, selection and summarization of the content, preparation of the booklet and its validation. Eleven judges specialized in Pediatrics participated in the study. For the validation process, the Delphi technique was used. Values equal to or greater than 0.80 were considered as a content validation index. Results: the booklet obtained satisfactory indexes in the categories content, language, illustration, layout, motivation, culture, and applicability, being validated in the second round with a global content validation index of 0.93. Conclusion: the objective of the study was achieved, with the booklet being constructed and validated by the expert judges, therefore, it can be a technological resource for the promotion of care for children in need of peripheral intravenous catheterization, configuring itself as a patient safety measure.


Subject(s)
Humans , Child , Catheterization , Health Education , Patient Education Handout , Pamphlets , Teaching Materials , Child Health , Education, Nursing , Evaluation Studies as Topic
5.
Rev. méd. Urug ; 37(2): e37211, 2021. tab, graf
Article in Spanish | LILACS, UY-BNMED | ID: biblio-1289850

ABSTRACT

Resumen: Identificar la causa de un síndrome de Cushing dependiente de adrenocorticotropina (ACTH) es esencial para realizar un tratamiento correcto. La hipersecreción de ACTH es debida en su mayoría a un tumor hipofisario (enfermedad de Cushing) o, en un 10%-20%, a tumores con producción ectópica de esta hormona. Los test no invasivos tienen baja sensibilidad y especificidad para diferenciar estas dos etiologías. El patrón oro lo constituye el cateterismo bilateral de los senos petrosos inferiores (CSP). Mediante el CSP se demuestra la hipersecreción de ACTH a nivel hipofisario al documentar un gradiente de ACTH central a periférico en el drenaje del tumor. Se recomienda realizarlo en todo síndrome de Cushing ACTH dependiente, aunque suele reservarse para pacientes con diagnóstico de hipercortisolismo y hallazgos negativos o equívocos en la resonancia nuclear magnética (RNM) de la región selar. Presentamos el primer caso en Uruguay en que se utilizó el CSP como método diagnóstico, una mujer de 55 años que presentó un hipercortisolismo ACTH-dependiente con una imagen adenohipofisaria <6 mm. El gradiente petroso-periférico confirmó el diagnóstico de enfermedad de Cushing y no hubo complicaciones durante el procedimiento. Posteriormente se realizó la resección del adenoma mediante cirugía transesfenoidal, con buena evolución y confirmación inmunohistoquímica del tumor.


Summary: Identifying the cause of adrenocorticotropin (ACTH)-dependent Cushing's syndrome is key to define the appropriate treatment. Hypersecretion of the adrenocorticotropic hormone (ACTH) is mainly caused by a pituitary tumor (Cushing's syndrome) or, in 10% to 20% of cases, by tumors with ectopic production of this hormone. Differentiation between these two etiologies may not be easy due to the low sensitivity and specificity of non- invasive tests. Bilateral sampling of the lower petrosal sinus is the gold standard to differentiate between a pituitary and an ectopic origin, showing the pituitary ACHT hypersecretion and recording the central-to-peripheral ACTH gradient in the tumor's drainage. Despite it being highly recommended for all cases of ACTH-dependent Cushing's syndrome, it is reserved for patients with a diagnosis of hypercortisolism and negative or misleading findings in the MRI of the sellar region. The study presents the first case of petrosal sinus sampling for diagnostic purposes in Uruguay, in a 55-year-old woman with ACHT-dependent hypercortisolism showing an adenohypophysis image < 6 mm. The petrosal-peripheral gradient confirmed the diagnosis of Cushing's syndrome and no complications arose during the procedure. Afterwards a transsphenoidal surgery was performed for resection of the adenoma. Evolution was good and immunochemistry confirmed the tumor's etiology.


Resumo: Identificar a causa da síndrome de Cushing dependente de adrenocorticotropina (ACTH) é essencial para o tratamento adequado. A hipersecreção de ACTH se deve principalmente a um tumor hipofisário (doença de Cushing) ou, em 10%-20%, a tumores com produção ectópica desse hormônio. Os testes não invasivos apresentam baixa sensibilidade e especificidade para diferenciar essas duas etiologias. O padrão ouro é o cateterismo bilateral dos seios petrosos inferiores (CEP). O CSP demonstra hipersecreção de ACTH no nível da hipófise, documentando um gradiente de ACTH central a periférico na drenagem do tumor. É recomendado nos casos de síndrome de Cushing dependente de ACTH, embora seja geralmente reservado para pacientes com diagnóstico de hipercortisolismo e achados negativos ou duvidosos na ressonância magnética (RNM) da região selar. Apresentamos o primeiro caso no Uruguai em que o CSP foi usado como método diagnóstico, uma mulher de 55 anos que apresentava hipercortisolismo ACTH dependente com imagem da hipófise anterior <6 mm. O gradiente petroso-periférico confirmou o diagnóstico de doença de Cushing e não houve complicações durante o procedimento. A seguir, o adenoma foi ressecado por cirurgia transesfenoidal, com boa evolução e confirmação imunohistoquímica do tumor.


Subject(s)
Cushing Syndrome/diagnosis , Cushing Syndrome/etiology , Catheterization , Petrosal Sinus Sampling
6.
Article in Chinese | WPRIM | ID: wpr-922043

ABSTRACT

This article aims to study the factors affecting the flexibility of the tip of an epidural anesthesia catheter. The flexibility of the tip of the epidural anesthesia catheter was tested with a softness tester from four aspects:raw materials, tip structure, tip processing technology, and the outer diameter of the catheter. Highly flexible and malleable polymer material with a smooth tip, the tip softening process and the proper outer diameter can effectively improve the tip flexibility of the epidural anesthesia catheter.


Subject(s)
Anesthesia, Epidural , Catheterization , Catheters , Epidural Space
7.
Chinese Journal of Burns ; (6): 101-112, 2021.
Article in Chinese | WPRIM | ID: wpr-880190

ABSTRACT

Deep vein catheterization is an important method to prevent and treat burn shock in severe burn patients, monitor hemodynamic changes and provide venous nutritional support. Although deep vein catheterization has been applied widely, there is no standard operation and management process. In order to guide the operation and management of deep vein catheterization in severe burn patients in a more scientific and standard manner, the consensus writing group organized domestic experts in burn field, most of whom are members of the 10th Committee of Chinese Burn Association to discuss and reach a consensus mainly in selection of deep vein catheter and the catheterization site, the method of catheterization operation, catheter maintenance, and prevention and treatment of catheter-related complications. This consensus aims to provide practical basis and guidance for the operation and management of deep vein catheterization in severe burn patients.


Subject(s)
Burns/therapy , Catheterization , Consensus , Humans , Monitoring, Physiologic , Shock
8.
Rev. colomb. anestesiol ; 48(4): e302, Oct.-Dec. 2020. graf
Article in English | LILACS, COLNAL | ID: biblio-1149789

ABSTRACT

Patients with Essential Thrombocythemia pose a variety of anesthetic challenges including a heightened risk of perioperative thrombosis. This condition is also associated with perioperative hemorrhage, risk for developing heparin induced thrombocytopenia type 2 during cardiac surgery and digital gangrene from radial artery catheterization.


Los pacientes con trombocitemia esencial plantean una variedad de desafíos anestésicos, incluido un mayor riesgo de trombosis perioperatoria. Esta condición también se asocia con hemorragia perioperatoria, riesgo de desarrollar trombocitopenia tipo 2 inducida por heparina durante la cirugía cardíaca y gangrena digital por cateterismo de la arteria radial.


Subject(s)
Humans , Thrombocytopenia , Thrombosis , Catheterization , Thrombocythemia, Essential , Thoracic Surgery , Radial Artery , Hemorrhage , Anesthetics
9.
Rev. colomb. anestesiol ; 48(4): e401, Oct.-Dec. 2020. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1144319

ABSTRACT

Abstract Introduction The use of extracorporeal membrane oxygenation (ECMO) has increased exponentially in recent years and has shown to be effective in treating adult respiratory distress syndrome (ARDS) secondary to HiNi-related pneumonia. However, evidence remains controversial. This study describes a case series of ECMO in ARDS secondary to viral pneumonia. Methods A search was conducted in the ECMO database of Fundación Cardiovascular de Colombia for the 20132017 period. A case series report was written of patients diagnosed with ARDS secondary to confirmed or suspected viral pneumonia. Results Nineteen patients with ECMO support and ARDS due to viral pneumonia were included in the study. The survival rate upon discharge was 11 patients (58%) and weaning from ECMO support was successful in 13 patients (68%). Hemorrhagic complications were the most frequent: gastrointestinal bleeding, 10 patients (53%); intracranial bleeding, 2 (10%); alveolar hemorrhage, 2 (10%);' hemothorax requiring thoracostomy with chest tube drainage, 2 (10%); cannulation site bleeding, 9 patients (47%); and surgical site bleeding in 3 patients (25%) who required tracheostomy. Other complications were: pneumothorax, 1 patient (5%); sepsis, 6 patients (32%); and growth of microorganisms in bronchial lavage, 6 patients (32%). Conclusions This study supports the use of veno-venous ECMO to achieve a higher survival rate than expected in patients with severe ARDS and refractory hypoxemia secondary to viral pneumonia. Early initiation of the therapy should improve overall results.


Resumen Introducción El uso de la oxigenación por membrana extracorpórea (ECMO) ha tenido un incremento exponencial en los últimos años y ha demostrado ser efectivo en el manejo del síndrome de dificultad respiratoria del adulto (SDRA) secundario a neumonía por H1N1, si bien la evidencia sigue siendo controvertida. En este estudio describimos una serie de casos de ECMO por SDRA secundario a neumonía viral. Métodos Se realizó una búsqueda en la base de datos de ECMO de la Fundación Cardiovascular desde el año 20132017. Reportamos una serie de casos donde se incluyeron pacientes diagnosticados con SDRA secundario a neumonía viral sospechosa o confirmada. Resultados Se incluyeron en el estudio 19 pacientes con soporte de ECMO y SDRA por neumonía viral. La sobrevida al alta fue 11 pacientes (58%) y el destete del ECMO fue exitoso en 13 pacientes (68%). Las complicaciones hemorrágicas presentadas fueron: sangrado digestivo, 10 pacientes (53%), sangrado cerebral, 2 (10%), hemorragia alveolar, 2 (10%), hemotórax con requerimiento de toracostomía a drenaje cerrado, 2 (10%), sangrado activo por sitio de canulación, 9 pacientes (53%), y 3 pacientes traqueostomizados (25%) que sangraron por el sitio quirúrgico. Otras complicaciones presentadas fueron: neumotórax, 1 paciente (5%), septicemia, 6 (32%) y crecimiento de microorganismos en lavados bronquiales 6 (32%). Conclusion El presente estudio permite indicar que el uso de la ECMO VV viabiliza una sobrevida mayor a la esperada en pacientes con SDRA severo e hipoxemia refractaria secundario a neumonía viral. Su inicio tempranamente debe mejorar los resultados globales.


Subject(s)
Humans , Male , Female , Middle Aged , Pneumonia, Viral , Poisons , Respiratory Distress Syndrome, Newborn , Extracorporeal Membrane Oxygenation , Chest Tubes , Hemothorax , Pneumothorax , Thoracostomy , Tracheostomy , Catheterization , Survival Rate , Sepsis , Bronchoalveolar Lavage , Influenza A Virus, H1N1 Subtype
10.
Rev. bras. cir. cardiovasc ; 35(6): 927-933, Nov.-Dec. 2020. tab
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1143998

ABSTRACT

Abstract Objective: To investigate the safety and cost-effectiveness of preoperative cannulation and conventional approach techniques. Methods: Sixty-one patients who underwent redo open cardiac procedures between September 2015 and November 2018 were divided into two groups - Group A (n: 30), patients who underwent conventional cannulation after sternotomy, and Group B (n: 31), those who underwent cannulation before sternotomy. Patients were evaluated retrospectively for general complication rates and total hospital costs. Results: Mortality occurred in four patients from Group A and in one patient from Group B. Four patients required extracorporeal membrane oxygenation (ECMO) in Group A, whereas two required ECMO in Group B. Duration of total operation, cardiopulmonary bypass, and cross-clamp times were longer in the conventional surgery group than in the pre-sternotomy cannulation group (420.29±188.84 vs. 314.77±187.38, P=0.036; 171.87±85.59 vs. 141.7±82.47, P=0.089; and 102.94±70.67 vs. 60.97±52.81, P=0.009; respectively). Total blood and blood product usage were higher in Group A than in Group B. Postoperative intensive care unit stay was 62.77±145.3 hours vs. 25.13±73.11 hours, ventilation time was 5.16±5.09 hours vs. 3.03±2.78 hours, duration of ward stay was 5.23±2.52 days vs. 5.57±2.16 days, and duration of hospital stay was 9.58±5.85 days vs. 9.8±5.31 days in conventional sternotomy and pre-sternotomy cannulation groups, respectively. Total hospital costs were calculated 35863.52±20803.99 Turkish Liras (TL) in Group A and 25744.74±16472.03 TL in Group B (P=0,042). Conclusion: Venous and arterial cannulations before sternotomy decreased myocardial injury and complication rates, blood and blood product usage, hospital stay, and, consequently, hospital costs in our modest cohort.


Subject(s)
Humans , Male , Female , Child , Adult , Catheterization , Cardiac Surgical Procedures/adverse effects , Preoperative Care , Retrospective Studies , Treatment Outcome , Cost-Benefit Analysis , Sternotomy/adverse effects
13.
Rev. bras. cir. cardiovasc ; 35(4): 420-426, July-Aug. 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1137301

ABSTRACT

Abstract Objective: To compare peripheral and central cannulation techniques in cardiac reoperation. Methods: This retrospective study included 258 patients undergoing cardiac reoperation between January 2013 and July 2018. Patients were divided into two groups according to the cannulation type. The first group included 145 (56.2%) patients operated with standard central cannulation through aorta and right atrium or bicaval cannulation. In this group, cardiopulmonary bypass was instituted after sternotomy. The second group consisted of 113 (43.8%) patients operated with peripheral cannulation through femoral artery, vein, and internal jugular vein. In this group, cardiopulmonary bypass was started before sternotomy and after systemic heparinisation. The two groups' operative complications and postoperative outcomes were compared. Results: Procedure-related injury was higher in the central cannulation group than in the peripheral cannulation group (8.3% vs. 1.8%, respectively, P=0.038). Cardiopulmonary bypass time was shorter in the central cannulation group (P=0.008) and total operation time was similar between the groups (P=0.115). Postoperative red blood cell requirement was higher with central cannulation (P=0.004). Operative mortality (2.8% vs. 0, P=0.186), hospital mortality (4.3% vs. 2.7%, P=0.523), and one-year survival rate (90.3% vs. 94.7%, P=0.202) were similar between the groups. Conclusion: Peripheral cannulation reduces cardiac injury and blood transfusion in cardiac reoperation. The cannulation type does not affect postoperative complication, mortality, and one-year survival.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Cardiac Surgical Procedures , Stroke Volume , Catheterization , Retrospective Studies , Ventricular Function, Left , Treatment Outcome
14.
Rev. colomb. nefrol. (En línea) ; 7(1): 135-142, ene.-jun. 2020. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1144381

ABSTRACT

Resumen La fístula arteriovenosa nativa (FAVn) constituye el acceso ideal en los pacientes de hemodiálisis, sin embargo, necesita un periodo de maduración desde su construcción quirúrgica; en este periodo, que suele tardar más de 8 semanas, se expone a los pacientes a un tiempo mayor con catéteres. El presente artículo describe cuatro casos de canulación temprana (<3 semanas) que se llevaron a cabo con base en la experticia del personal de enfermería y algunos criterios ecográficos.


Abstract The native arteriovenous fistula (nAVF) is the ideal access in patients in hemodialysis, however, traditionally requires a period of maturation from its surgical construction that usually takes more than 8 weeks, exposing patients to a longer time with catheters; In this article, we describe 4 cases of early cannulation (<3 weeks) based on nursing staff expertise and ultrasound criteria.


Subject(s)
Humans , Male , Female , Renal Insufficiency, Chronic , Catheterization , Arteriovenous Fistula , Renal Dialysis , Colombia , Vascular Access Devices
16.
Rev. bras. cir. cardiovasc ; 35(1): 28-33, Jan.-Feb. 2020. tab
Article in English | LILACS | ID: biblio-1092467

ABSTRACT

Abstract Introduction: One of the most important points of the acute type A aortic dissection surgery is how to perform cannulation regarding cerebral protection concerns and the conditions of arterial structures as a pathophysiological consequence of the disease. Objective: In this study, femoral and axillary cannulation methods were compared in acute type A aortic dissection operations. Methods: The study retrospectively evaluated 52 patients who underwent emergency surgery for acute type A aortic dissection. Patients without malperfusion according to Penn Aa classification were chosen for preoperative standardization of the study groups. The femoral arterial cannulation group was group 1 (n=22) and the axillary arterial cannulation group was group 2 (n=30). The groups were compared in terms of perioperative and postoperative results. Results: There was no statistically significant difference in terms of preoperative data. In terms of postoperative parameters, especially early mortality and new-onset cerebrovascular event, there was no statistically significant difference. Mortality rates in group 1 and group 2 were 13.6% (n=3) and 10% (n=3), respectively (P=0.685). Postoperative new-onset cerebral events ratio was found in 5 (22.7%) in the femoral cannulation group and 6 (20%) in the axillary cannulation group (P=0.812). Conclusion: Both femoral and axillary arterial cannulation methods can be safely performed in patients with acute type A aortic dissection, provided that cerebral protection strategies should be considered in the first place. The method to be performed may vary depending on the patient's current medical condition or the surgeon's preference.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Axillary Artery/surgery , Femoral Artery , Femur/surgery , Aneurysm, Dissecting , Vascular Surgical Procedures , Catheterization , Retrospective Studies , Treatment Outcome
17.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1087516

ABSTRACT

Objetivo: descrever os cuidados da equipe de enfermagem aos clientes portadores de Fistula Arteriovenosa (FAV). Método: revisão integrativa de literatura, que utilizou como questão de busca: quais são os cuidados da equipe de enfermagem aos clientes portadores de fístula arteriovenosa? A busca foi realizada na Biblioteca Virtual de Saúde, nas bases de dados: MEDLINE, LILACS e BDENF; PubMed; Portal de Periódicos da Capes, nas bases SCOPUS e CINAHL, em agosto de 2018. Resultados: foram encontrados três artigos indexados na LILACS e dois na CINAHL. Emergiu a categoria analítica do estudo intitulada: Cuidados de enfermagem aos clientes portadores de FAV, e duas unidades de decodificação: "Incorporação de evidências sobre a FAV, para se pensar os cuidados de enfermagem" e "Atuação da equipe de enfermagem na preservação da FAV: pensando o autocuidado". Conclusões: os cuidados de enfermagem aos clientes portadores de FAV perpassaram pela durabilidade e a manutenção do seu funcionamento


Objective: to describe the care of nursing staff to customers bearers of Arteriovenous Fistula (AVF). Method: integrative Review of literature, which used as search question: what are the care of nursing staff to customers bearers of arteriovenous fistula? The search was conducted in the health Virtual Library, in the databases BDENF, LILACS and MEDLINE; PubMed; Capes Journal Portal, CINAHL, SCOPUS and bases in August 2018. Results: were found three articles indexed at LILACS and two in CINAHL. Analytical category emerged the study entitled: nursing care to clients suffering from AVF, and two units of decoding: "incorporation of evidence about the FAV, to think about nursing care" and "performance of nursing staff in preservation of FAV: thinking self-care". Conclusions: the nursing care to clients suffering from perpassaram FAV durability and maintenance of your operation


Objetivo: para describir el cuidado de enfermería personal para portadores de clientes de la fístula arteriovenosa (AVF). Método: integral revisión de la literatura, que utiliza como pregunta de la búsqueda: ¿Cuáles son los cuidados de enfermería personal para portadores de fístula arteriovenosa de los clientes? La búsqueda se realizó en la Biblioteca Virtual, de la salud en las bases de datos, BDENF, LILACS y MEDLINE; PubMed; CAPES Portal diario, CINAHL, SCOPUS y en agosto de 2018. Resultados: se encontraron tres artículos indizados en LILACS y dos en CINAHL. Categoría analítica surgió el estudio titulado: atención a clientes de AVF y dos unidades de decodificación de enfermería: "incorporación de la evidencia acerca de la FAV, a pensar en cuidados de enfermería" y "rendimiento del personal de enfermería preservación de la FAV: autocuidado de pensamiento" . Conclusiones: la atención de enfermería a clientes que sufren de perpassaram FAV durabilidad y mantenimiento de su operación


Subject(s)
Humans , Male , Female , Arteriovenous Fistula/nursing , Nephrology Nursing/trends , Nursing, Team , Catheterization/nursing , Renal Dialysis/nursing , Vascular Access Devices/trends
19.
Orient Journal of Medicine ; 32(1-2): 46-54, 2020. ilus
Article in English | AIM, AIM | ID: biblio-1268296

ABSTRACT

Background: Urethral stricture is an abnormal narrowing or loss of distensibility of any segment of the urethra surrounded by corpus spongiosum. In the last two decades, there has been a change in the pattern of aetiology of urethral stricture in urban centres in Nigeria with a shift away from post-infective strictures to the emergence of traumatic and iatrogenic causes.Objective: This study aims to present our observation of the occurrence of long-segment urethral strictures in patients after urethral catheter placement for various indications.Methodology: This is a descriptive, cross sectional report of patients who presented to and were managed at the Urology Unit of a tertiary hospital in North-Western Nigeria. Relevant information were retrieved from patients' case notes and the data was entered into a proforma and analysed using the SPSS 20 software.Results: The mean age of the patients was 45.4 ± 19.4 years, with a range of 11-80 years. Indications for urethral catheterization were acute urine retention 11 (43.8%), intra-operative urine output monitoring 9 (28.1%), following road traffic accident 10(31.2%), unconsciousness secondary to meningitis 1 (3.1%) and after urologic surgery 1 (3.1%). Urethral catheterization was carried out in peripheral hospitals in 19 (56.3%) patients; and from the hospitals operating room in 10 (31.2%), accident and emergency room 2 (6.3%) and trauma centre 1 (3.1%). Strictures were panurethral in 22 (68.75%), in the bulbar urethra in 6 (18.75%) and in the penile urethra 4 (12.5%). The length of strictures ranged from 1 cm to 20 cm. Treatments offered included substitution urethroplasty using oral mucosa grafts (OMG) urethroplasty 30 (93.8%), fasciocutaneous penile flap 1 (3.1%) and direct visual internal urethrotomy (DVIU)1 (3.1%). Satisfactory voiding was recorded in 28 (87.5%), voiding was unsatisfactory in 2 (6.3%), while one patient had stricture recurrence and another one is awaiting second stage repair.Conclusion: Urethral catheterization is an emerging cause of panurethral strictures in our practice and may occur even after relief of acute urine retention but more worrisome following short-term catheterization during surgery. There is need for evaluation of the quality of silicone-coated latex urethral catheters currently available


Subject(s)
Catheterization/complications , Latex Hypersensitivity , Nigeria , Urethral Stricture , Urinary Catheters
20.
Article in English | WPRIM | ID: wpr-810984

ABSTRACT

OBJECTIVE: To evaluate the technical feasibility of intranodal lymphangiography and thoracic duct (TD) access in a canine model.MATERIALS AND METHODS: Five male mongrel dogs were studied. The dog was placed in the supine position, and the most prominent lymph node in the groin was accessed using a 26-gauge spinal needle under ultrasonography (US) guidance. If the cisterna chyli (CC) was not opacified by bilateral lymphangiography, the medial iliac lymph nodes were directly punctured and Lipiodol was injected. After opacification, the CC was directly punctured with a 22-gauge needle. A 0.018-in microguidewire was advanced through the CC and TD. A 4-Fr introducer and dilator were then advanced over the wire. The microguidewire was changed to a 0.035-in guidewire, and this was advanced into the left subclavian vein through the terminal valve of the TD. Retrograde TD access was performed using a snare kit.RESULTS: US-guided lymphangiography (including intranodal injection of Lipiodol [Guerbet]) was successful in all five dogs. However, in three of the five dogs (60%), the medial iliac lymph nodes were not fully opacified due to overt Lipiodol extravasation at the initial injection site. In these dogs, contralateral superficial inguinal intranodal injection was performed. However, two of these three dogs subsequently underwent direct medial iliac lymph node puncture under fluoroscopy guidance to deliver additional Lipiodol into the lymphatic system. Transabdominal CC puncture and cannulation with a 4-Fr introducer was successful in all five dogs. Transvenous retrograde catheterization of the TD (performed using a snare kit) was also successful in all five dogs.CONCLUSION: A canine model may be appropriate for intranodal lymphangiography and TD access. Most lymphatic intervention techniques can be performed in a canine using the same instruments that are employed in a clinical setting.


Subject(s)
Animals , Catheterization , Catheters , Dogs , Ethiodized Oil , Fluoroscopy , Groin , Humans , Lymph Nodes , Lymphatic System , Lymphography , Male , Needles , Punctures , SNARE Proteins , Subclavian Vein , Supine Position , Thoracic Duct , Ultrasonography
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