Transfusion of Blood Products in the Postoperative of Cardiac Surgery

Abstract Background: The indiscriminate use of blood transfusion in surgery has been associated with increased risk of infection and increased length of hospital stay. Objective: To identify the average amount of bleeding and rates of transfusion of blood products in the postoperative period of patients undergoing cardiac surgery in a cardiology center. Methods: Medical records of patients who underwent myocardial revascularization surgery and/or heart valve replacement with use of cardiopulmonary bypass (CPB) were analyzed. Perioperative data such as CPB time, hematocrit and hemoglobin values were collected after surgery. The amount of bleeding (mL), blood transfusion (IU), clinical complications and time of hospitalization were also recorded. The correlation between bleeding in the postoperative period and blood transfusion was performed using the Spearman correlation. A p < 0.05 was considered statistically significant. Results: A total of 423 patients undergoing coronary artery bypass grafting (51.5%) or heart valve replacement (33.6%) were included. During the first 24 hours, the average bleeding volume was 353.3 ± 268.3 mL. Transfusion of blood products was required in 40.1% of cases, most frequently (70.6%) in the immediate postoperative period. Red blood cell concentrate was the most frequently used product (22.9% and 60%). Conclusion: The occurrence of bleeding in the cases was low, and when transfusion of blood components was indicated, red blood cell concentrates were the most widely used component. (Int J Cardiovasc Sci. 2021; [online].ahead print, PP.0-0)

The effect of caffeine supplementation on exercise performance evaluated by a novel animal model

Introduction: Caffeinated drinks are used for improve performance. Animal models represent investigational strategy that circumvents most of the drawbacks of research in humans, including motivational factors and the placebo effect. No animal model that could test whether different forms of administering caffeine affect exercise propensity was found in the literature. Methods: An animal model of grouped voluntary exercise was tested. Two-month-old male C57/bl mice were housed in a cage fitted with one running wheel and a monitoring system. Six animals per cage were introduced individually. To assess the sensitivity of the model, the effect of different caffeinated drinks was observed in mice exercising ad libitum. During 2 days, the mice received: 1) pure anhydrous caffeine 0.125 mg/mL (PC), 2) cola drink (CC), and 3) caffeine-taurine-glucuronolactone drink (CTG), intercalating wash-out periods of 2 days, receiving pure water. Results: The distance run during the periods of water ingestion was significantly lower than during the periods of stimulant drinks ingestion: PC (5.6 ± 1.3 km; p = 0.02), of CC ingestion (7.6 ± 0.6 km; p = 0.001), and of CTG ingestion (8.3 ± 1.6 km; p = 0.009). The performances when ingesting the three caffeinated drinks do not follow a dose-response curve. Conclusions: The model described here was able to measure the effect of caffeine intake on voluntary exercise of mice. The sensitivity of the model to the effect of caffeine needs to be further validated. The action of each component of the drinks on exercise performance needs to be clarified in future research. The present model is adequate for such investigation (AU)

Percepção dos enfermeiros frente às atividades gerenciais na assistência ao usuário / Perception of nurses regarding management activities for user assistance

OBJETIVO: Identificar a percepção de enfermeiros de um hospital geral sobre as atividades gerenciais na assistência aos usuários. MÉTODOS: Estudo de natureza qualitativa, exploratória descritiva. Os sujeitos da pesquisa foram 13 enfermeiros de um hospital filantrópico. A coleta de dados foi realizada por meio de entrevista semiestruturada, no período de janeiro e fevereiro de 2010. No tratamento dos resultados utilizou-se a análise do conteúdo. RESULTADOS: As atividades gerenciais sobressaíram no processo de trabalho do enfermeiro e, que decorrente deste fator, a assistência direta ao usuário foi delegada a outros profissionais da equipe. CONCLUSÃO: Os enfermeiros compreendem a importância de articular as ações assistenciais e gerenciais, sendo estas últimas vistas como complementaridade do cuidado.

OBJECTIVE: To identify the perceptions of nurses in a general hospital about managerial activities for user assistance. METHODS: A qualitative, exploratory and descriptive study. The research subjects were 13 nurses from a philanthropic hospital. Data collection was conducted by means of semi-structured interviews, during the period of January and February, 2010. For interpretation of the results, content analysis was used. RESULTS: The management activities highlighted in the process of nursing work, and that resulted in the direct assistance to the user, have been delegated to other professionals in the team. CONCLUSION: The nurses understand the importance of linking clinical and managerial actions, the latter being seen as complementary to care.

OBJETIVO: Identificar la percepción de enfermeros de un hospital general sobre las actividades gerenciales en la asistencia a los usuarios. MÉTODOS: Se trata de un estudio de naturaleza cualitativa, exploratoria descriptiva. Los sujetos de la investigación fueron 13 enfermeros de un hospital filantrópico.La recolección de los datos fue realizada por medio de entrevista semiestructurada, en el período de enero y febrero del 2010. Para el tratamiento de los resultados se utilizó el análisis de contenido. RESULTADOS: Las actividades gerenciales sobresalieron en el proceso de trabajo del enfermero y, que en consecuencia de este factor, la asistencia directa al usuario fue delegada a otros profesionales del equipo. CONCLUSIÓN: Los enfermeros comprenden la importancia de articular las acciones asistenciales y gerenciales, siendo estas últimas vistas como complementariedad del cuidado.