ABSTRACT
OBJECTIVE: The aim of this study was to evaluate outcome measures between our standard multidose cardioplegia protocol and a del Nido cardioplegia protocol in congenital heart surgery patients. METHODS: Retrospective single-center study including 250 consecutive patients that received del Nido cardioplegia (DN group) with a mandatory reperfusion period of 30% of cross clamp time and 250 patients that received a modified St. Thomas' solution (ST group). Groups were matched by age, weight, gender, and Risk Adjustment for Congenital Heart Surgery (RACHS-1) scores. Preoperative hematocrit and oxygen saturation were also recorded. Outcomes analyzed were the vasoactive inotropic score (VIS), lactate, ventilation time, ventricular dysfunction with low cardiac output syndrome (LCOS), intensive care unit (ICU) length of stay (LOS), hospital LOS, bypass and aortic cross-clamp times, and in-hospital mortality. RESULTS: Both groups were comparable demographically. Statistically significant differences (p ⩽ 0.05) were noted for cardiac dysfunction with LCOS, hematocrit at end of surgery (p = 0.0038), VIS on ICU admission and at end of surgery (p = 0.0111), and ICU LOS (p = 0.00118) with patients in the DN group having more desirable values for those parameters. Other outcome measures did not reach statistical significance. CONCLUSION: In our congenital cardiac surgery population, del Nido cardioplegia strategy was associated with less ventricular dysfunction with LCOS, a lower VIS and decreased ICU LOS compared with patients that received our standard myocardial protection using a modified St. Thomas' solution. Despite the limitation of this study, including its retrospective nature and cohort size, these data supported our transition to incorporate del Nido cardioplegia solution with a mandatory reperfusion period as the preferred myocardial protection method in our program.
Subject(s)
Cardiac Surgical Procedures , Heart Defects, Congenital , Ventricular Dysfunction , Brazil , Cardiac Output, Low , Cardioplegic Solutions/therapeutic use , Child , Electrolytes , Heart Arrest, Induced/methods , Heart Defects, Congenital/surgery , Humans , Lactates , Lidocaine , Magnesium Sulfate , Mannitol , Potassium Chloride , Retrospective Studies , Sodium Bicarbonate , Solutions , Ventricular Dysfunction/drug therapyABSTRACT
O emprego da fitoterapia esteve presente ao longo da história, sendo utilizada no tratamento das enfermidades que acometem o ser humano. Tal afirmativa também é válida para a saúde animal, principalmente em comunidades rurais. Este projeto objetivou resgatar o conhecimento popular sobre o uso de plantas medicinais em animais nas comunidades do Assentamento Rural Sol da Manhã e do Mutirão Eldorado, situadas no município de Seropédica. Foram realizadas visitas aos assentamentos, aplicando-se questionários sobre indicações terapêuticas e formas de utilização das espécies no tratamento de animais domésticos. Exemplares das espécies utilizadas foram identificados pelo Departamento de Botânica da Universidade Federal Rural do Rio de Janeiro (UFRRJ). No total foram entrevistadas 52 famílias, das quais 63,5% afirmaram utilizar plantas medicinais no tratamento de saúde dos seus animais. Dentre as 30 espécies medicinais citadas foram evidenciadas 12 indicações gerais, das quais três destacaram-se: anti-helmíntica (36,58%), anti-inflamatória (17,07%), e repelente (12,19%), caracterizando a importância do emprego das plantas no tratamento de doenças parasitárias, sendo a principal espécie indicada para esse uso o Chenopodium ambrosioides L. (erva-de-santa-maria) com 25% das citações. A correlação entre o conhecimento popular e as pesquisas científicas pode gerar novas intervenções terapêut
