ABSTRACT
INTRODUCTION: Mediastinitis is one of the most feared complications for thoracic surgeons, being a significant factor in morbidity and mortality in thoracic surgery. OBJECTIVE: To find a new alternative in order to prevent mediastinitis, reducing the morbidity and mortality. METHODS: A retrospective study including 1020 patients operated between February 2002 and October 2005. Patients underwent bypass surgery and vancomycin paste was used rather than bone wax in all cases. RESULTS: Patients were followed-up for 45 months; there were only five (0.49%) cases of mediastinitis; no deaths were observed. CONCLUSION: The use of Vancomycin paste to replace bone wax proved to be a great allied to prevent mediastinitis after thoracic surgery.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Antibiotic Prophylaxis , Cardiac Surgical Procedures , Mediastinitis/prevention & control , Surgical Wound Infection/prevention & control , Vancomycin/therapeutic use , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/administration & dosage , Coronary Artery Bypass , Female , Follow-Up Studies , Hemostasis , Humans , Male , Middle Aged , Postoperative Complications/prevention & control , Postoperative Period , Retrospective Studies , Sternum/microbiology , Sternum/surgery , Vancomycin/administration & dosageABSTRACT
INTRODUÇÃO: A mediastinite é uma das complicações mais temidas pelos cirurgiões cardiovasculares, sendo esta um fator importante na morbidade e mortalidade em cirurgia cardíaca. OBJETIVO: Buscar uma nova opção na prevenção da mediastinite, diminuindo o índice de morbidade e mortalidade. MÉTODOS: Estudo retrospectivo que incluiu 1020 pacientes submetidos a cirurgia cardíaca, no período de fevereiro de 2002 a outubro de 2005. Os pacientes foram submetidos a cirurgia com uso de circulação extracorpórea e implementação da vancomicina em pasta em substituição a cera de osso. RESULTADOS: Os pacientes foram seguidos ao longo de 45 meses, apenas cinco (0,49 por cento) desenvolveram mediastinite e não houve óbito. CONCLUSÃO: O uso de vancomicina em pasta em substituição à cera de osso mostrou-se ser uma aliada na prevenção da mediastinite no pós-operatório de cirurgia cardíaca.
INTRODUCTION: Mediastinitis is one of the most feared complications for thoracic surgeons, being a significant factor in morbidity and mortality in thoracic surgery. OBJECTIVE: To find a new alternative in order to prevent mediastinitis, reducing the morbidity and mortality. METHODS: A retrospective study including 1020 patients operated between February 2002 and October 2005. Patients underwent bypass surgery and vancomycin paste was used rather than bone wax in all cases. RESULTS: Patients were followed-up for 45 months; there were only five (0.49 percent) cases of mediastinitis; no deaths were observed. CONCLUSION: The use of Vancomycin paste to replace bone wax proved to be a great allied to prevent mediastinitis after thoracic surgery.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Antibiotic Prophylaxis , Anti-Bacterial Agents/therapeutic use , Cardiac Surgical Procedures , Mediastinitis/prevention & control , Surgical Wound Infection/prevention & control , Vancomycin/therapeutic use , Anti-Bacterial Agents/administration & dosage , Coronary Artery Bypass , Follow-Up Studies , Hemostasis , Postoperative Period , Postoperative Complications/prevention & control , Retrospective Studies , Sternum/microbiology , Sternum/surgery , Vancomycin/administration & dosageABSTRACT
The assessment and stratification of patients with chest pain in the emergency unit may indicate the appropriate therapy for each patient based on the probability of the presence of acute coronary artery disease and on the risk of its major cardiac events. That assessment is based on the triplet: clinical setting, electrocardiographic findings, and markers of myocardial lesion. We report the case of a 58-year-old male chagasic patient admitted to the emergency unit due to chest pain and palpitations, with an electrocardiogram showing sustained ventricular tachycardia and positive troponin measurement (0.99 ng/mL). The patient underwent cine coronary angiography, which evidenced no obstructive coronary artery disease.
Subject(s)
Chagas Cardiomyopathy/blood , Tachycardia, Ventricular/diagnosis , Troponin T/blood , Amiodarone/therapeutic use , Anti-Arrhythmia Agents/therapeutic use , Biomarkers/blood , Cineangiography , Coronary Angiography , Electrocardiography , Humans , Male , Middle Aged , Tachycardia, Ventricular/drug therapyABSTRACT
A avaliação e estratificação de pacientes com dor torácica na sala de emergência pode nos direcionar a terapêutica adequada a cada paciente baseada na probabilidade da presença de doença coronariana aguda e no risco de eventos cardíacos maiores desta coronariopatia. Esta avaliação é baseada no tripé: quadro clínico, achados eletrocardiográficos e nos marcadores de lesão miocárdica. Relatamos o caso de um paciente chagásico de 58 anos de idade admitido na unidade de emergência por dor torácica e palpitações, com eletrocardiograma mostrando uma taquicardia ventricular sustentada e com dosagem de troponina positiva (0,99 ng/ml), submetido a cinecoronariografia, que não evidenciou doença coronariana obstrutiva.
