RESUMO
OBJECTIVE: We investigated the potential association of cerebral autoregulation (CA) with postoperative delirium (PD), a common complication of cardiac surgery with cardiopulmonary bypass (CPB). METHODS: In patients undergoing coronary artery bypass graft (CABG) surgery with CPB, cerebral blood flow velocity (CBFV) and blood pressure (BP) were continuously recorded during 5-min preoperatively (T1), after 24â¯h (T2), and 7â¯days after procedure (T3). Prospective multivariate logistic regression analysis was performed to determine the independent risk factors of PD. Autoregulation index (ARI) was calculated from the CBFV response to a step change in BP derived by transfer function analysis. RESULTS: In 67 patients, mean age 64.3⯱â¯9.5â¯years, CA was depressed at T2 as shown by values of ARI (3.9⯱â¯1.7), compared to T1 (5.6⯱â¯1.7) and T3 (5.5⯱â¯1.8) (pâ¯<â¯0.001). Impaired CA was found in 37 (55%) patients at T2 and in 7 patients (20%) at T3. Lower ARI at T1 and T2 were predictors of PD (pâ¯=â¯0.003). CONCLUSION: Dynamic CA was impaired after CABG surgery with CPB and was a significant independent risk factor of PD. SIGNIFICANCE: Assessment of CA before and after surgery could have considerable potential for early identification of patients at risk of PD, thus reducing poor outcomes and length of stay. CLINICAL TRIALS REGISTRATION: www.clinicaltrials.gov (NCT02143544, April 30, 2014).
Assuntos
Circulação Cerebrovascular/fisiologia , Ponte de Artéria Coronária/efeitos adversos , Delírio/epidemiologia , Homeostase/fisiologia , Complicações Pós-Operatórias/epidemiologia , Idoso , Ponte de Artéria Coronária/tendências , Delírio/diagnóstico , Delírio/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/fisiopatologia , Estudos ProspectivosRESUMO
Pesquisa descritiva e transversal que teve como objetivo identificar a qualidade de vida de pacientes hipertensos em tratamento ambulatorial. Participaram 88 pacientes hipertensos, a maioria mulheres, atendidos num ambulatório de especialidades do interior do Estado de São Paulo. Para a coleta de dados foram utilizados: uma ficha de caracterização sociodemográfica e Mini-Cuestionario de Calidad de Vida en Hiperténsion Arterial, adaptado e validado para a cultura brasileira
