Brazilian Journal of Anesthesiology最新文献

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Fluid therapy and pulmonary complications in abdominal surgeries: randomized controlled trial 腹部手术中的液体疗法和肺部并发症:随机对照试验。
IF 1.3 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-03-29 DOI: 10.1016/j.bjane.2024.844500
Gabriel Isaac Pereira de Castro , Renata Sayuri Ansai Pereira de Castro , Rodrigo Moreira e Lima , Bruna Nogueira dos Santos , Lais Helena Navarro e Lima
{"title":"Fluid therapy and pulmonary complications in abdominal surgeries: randomized controlled trial","authors":"Gabriel Isaac Pereira de Castro ,&nbsp;Renata Sayuri Ansai Pereira de Castro ,&nbsp;Rodrigo Moreira e Lima ,&nbsp;Bruna Nogueira dos Santos ,&nbsp;Lais Helena Navarro e Lima","doi":"10.1016/j.bjane.2024.844500","DOIUrl":"10.1016/j.bjane.2024.844500","url":null,"abstract":"<div><h3>Background</h3><p>There is no consensus on the most effective strategy for Postoperative Pulmonary Complication (PPC) reduction. This study hypothesized that a Goal-Directed Fluid Therapy (GDFT) protocol of infusion of predetermined boluses reduces the occurrence of PPC in patients undergoing elective open abdominal surgeries when compared with Standard of Care (SOC) strategy.</p></div><div><h3>Methods</h3><p>Randomized, prospective, controlled study, conducted from May 2012 to December 2014, with ASA I, II or III patients undergoing open abdominal surgeries, lasting at least 120 min, under general anesthesia, randomized into the SOC and the GDFT group. In the SOC, fluid administration was according to the anesthesiologist's discretion. In the GDFT, the intervention protocol, based on bolus infusion according to blood pressure and delta pulse pressure, was applied. Patients were postoperatively evaluated by an anesthesiologist blinded to the group allocation regarding PPC incidence, mortality, and Length of Hospital Stay (LOHS).</p></div><div><h3>Results</h3><p>Forty-two patients in the SOC group and 43 in the GDFT group. Nineteen patients (45%) in the SOC and 6 in the GDFT (14%) had at least one PPC (<em>p</em> = 0.003). There was no difference in mortality or LOHS between the groups. Among the patients with PPC, four died (25%), compared to two deaths in patients without PPC (3%) (<em>p</em> = 0.001). The LOHS had a median of 14.5 days in the group with PPC and 9 days in the group without PPC (<em>p</em> = 0.001).</p></div><div><h3>Conclusion</h3><p>The GDFT protocol resulted in a lower rate of PPC; however, the LOHS and mortality did not reduce.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001424000228/pdfft?md5=c8ad0071a7100e86aca972abfac00f6a&pid=1-s2.0-S0104001424000228-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140330430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of terbutaline and atosiban as tocolytic agents in intrauterine repair of myelomeningocele: a retrospective cohort study 特布他林和阿托西班作为子宫肌膜膨出宫内修复术中溶血剂的比较:一项回顾性队列研究。
IF 1.3 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-03-22 DOI: 10.1016/j.bjane.2024.844495
Shirley Andrade Santos , Fernando Souza Nani , Elaine Imaeda de Moura , Diogo Lima de Carvalho , Guilherme Jorge Mattos Miguel , Cristiane Maria Federicci Haddad , Joaquim Edson Vieira , Victor Bunduki , Mário Henrique Burlacchini de Carvalho , Rossana Pulcineli Vieira Francisco , Daniel Dante Cardeal , Hermann dos Santos Fernandes
{"title":"Comparison of terbutaline and atosiban as tocolytic agents in intrauterine repair of myelomeningocele: a retrospective cohort study","authors":"Shirley Andrade Santos ,&nbsp;Fernando Souza Nani ,&nbsp;Elaine Imaeda de Moura ,&nbsp;Diogo Lima de Carvalho ,&nbsp;Guilherme Jorge Mattos Miguel ,&nbsp;Cristiane Maria Federicci Haddad ,&nbsp;Joaquim Edson Vieira ,&nbsp;Victor Bunduki ,&nbsp;Mário Henrique Burlacchini de Carvalho ,&nbsp;Rossana Pulcineli Vieira Francisco ,&nbsp;Daniel Dante Cardeal ,&nbsp;Hermann dos Santos Fernandes","doi":"10.1016/j.bjane.2024.844495","DOIUrl":"10.1016/j.bjane.2024.844495","url":null,"abstract":"<div><h3>Background</h3><p>Myelomeningocele (MMC) is a neural tube defect disease. Antenatal repair of fetal MMC is an alternative to postnatal repair. Many agents can be used as tocolytics during the in utero fetal repair such as β2-agonists and oxytocin receptor antagonists, with possible maternal and fetal repercussions. This study aims to compare maternal arterial blood gas analysis between terbutaline or atosiban, as tocolytic agents, during intrauterine MMC repair.</p></div><div><h3>Methods</h3><p>Retrospective cohort study. Patients were divided into two groups depending on the main tocolytic agent used during intrauterine MMC repair: atosiban (16) or terbutaline (9). Maternal arterial blood gas samples were analyzed on three moments: post induction (baseline, before the start of tocolysis), before extubation, and two hours after the end of the surgery.</p></div><div><h3>Results</h3><p>Twenty-five patients were included and assessed. Before extubation, the terbutaline group showed lower arterial pH (7.347 ± 0.05 vs. 7.396 ± 0.02 for atosiban, <em>p</em> = 0.006) and higher arterial lactate (28.33 ± 12.76 mg.dL<sup>−1</sup> vs. 13.06 ± 6.35 mg.dL<sup>−1</sup>, for atosiban, <em>p</em> = 0.001) levels.</p></div><div><h3>Conclusions</h3><p>Patients who received terbutaline had more acidosis and higher levels of lactate, compared to those who received atosiban, during intrauterine fetal MMC repair.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001424000174/pdfft?md5=dbaa845b4aa6c764f06ad927577cbfab&pid=1-s2.0-S0104001424000174-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140195268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of the learning curve of peribulbar blocks using the Learning-Curve Cumulative Sum Method (LC-CUSUM): an observational study 使用学习曲线累积和法(LC-CUSUM)评估球周阻滞的学习曲线。一项观察性研究。
IF 1.3 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-03-01 DOI: 10.1016/j.bjane.2023.11.003
Getúlio Rodrigues de Oliveira Filho, Victor Medeiros Benincá
{"title":"Assessment of the learning curve of peribulbar blocks using the Learning-Curve Cumulative Sum Method (LC-CUSUM): an observational study","authors":"Getúlio Rodrigues de Oliveira Filho,&nbsp;Victor Medeiros Benincá","doi":"10.1016/j.bjane.2023.11.003","DOIUrl":"10.1016/j.bjane.2023.11.003","url":null,"abstract":"<div><h3>Introduction</h3><p>This study aimed to assess the learning curves of peribulbar anesthesia and estimate the number of blocks needed to attain proficiency.</p></div><div><h3>Methods</h3><p>Anonymized records of sequential peribulbar blocks performed by first-year anesthesia residents were analyzed. The block sequential number and the outcomes were extracted from each record. Success was defined as a complete sensory and motor block of the eye, and failure was defined as an incomplete block requiring supplemental local anesthetic injections or general anesthesia. Learning curves using the LC-CUSUM method were constructed, aiming for acceptable and unacceptable failure rates of 10% and 20%, and 10% probability of type I and II errors. Simulations were used to determine the proficiency limit h<sub>0</sub>. Residents whose curves reached h<sub>0</sub> were considered proficient. The Sequential Probability Ratio Test Cumulative Sum Method (SPRT-CUSUM) was used for follow-up.</p></div><div><h3>Results</h3><p>Thirty-nine residents performed 2076 blocks (median = 52 blocks per resident; Interquartile Range (IQR) [range] = 27–78 [4–132]). Thirty residents (77%) achieved proficiency after a median of 13 blocks (13–24 [13–24]).</p></div><div><h3>Conclusions</h3><p>The LC-CUSUM is a robust method for detecting resident proficiency at peribulbar anesthesia, defined as success rates exceeding 90%. Accordingly, 13 to 24 supervised double-injection peribulbar blocks are needed to attain competence at peribulbar anesthesia.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001423001185/pdfft?md5=d92aed10921eeac2f8fa66031b01d206&pid=1-s2.0-S0104001423001185-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134650563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
High-flow nasal therapy: a game-changer in anesthesia and perioperative medicine? 高流量鼻腔治疗:麻醉和围手术期医学的游戏规则改变者?
IF 1.3 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-03-01 DOI: 10.1016/j.bjane.2023.09.005
Desire T. Maioli , Cristiano F. Andrade , Clovis T. Bevilacqua Filho , André P. Schmidt
{"title":"High-flow nasal therapy: a game-changer in anesthesia and perioperative medicine?","authors":"Desire T. Maioli ,&nbsp;Cristiano F. Andrade ,&nbsp;Clovis T. Bevilacqua Filho ,&nbsp;André P. Schmidt","doi":"10.1016/j.bjane.2023.09.005","DOIUrl":"10.1016/j.bjane.2023.09.005","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001423001008/pdfft?md5=c5d3540aa947c25085c52fac2e4f1b70&pid=1-s2.0-S0104001423001008-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41180619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between preoperative anemia optimization and major complications after non-cardiac surgery: a retrospective analysis 术前贫血优化与非心脏手术后主要并发症的关系:回顾性分析。
IF 1.3 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-03-01 DOI: 10.1016/j.bjane.2023.11.004
Federico Almonacid-Cardenas , Eva Rivas , Moises Auron , Lucille Hu , Dong Wang , Liu Liu , Deborah Tolich , Edward J. Mascha , Kurt Ruetzler , Andrea Kurz , Alparslan Turan
{"title":"Association between preoperative anemia optimization and major complications after non-cardiac surgery: a retrospective analysis","authors":"Federico Almonacid-Cardenas ,&nbsp;Eva Rivas ,&nbsp;Moises Auron ,&nbsp;Lucille Hu ,&nbsp;Dong Wang ,&nbsp;Liu Liu ,&nbsp;Deborah Tolich ,&nbsp;Edward J. Mascha ,&nbsp;Kurt Ruetzler ,&nbsp;Andrea Kurz ,&nbsp;Alparslan Turan","doi":"10.1016/j.bjane.2023.11.004","DOIUrl":"10.1016/j.bjane.2023.11.004","url":null,"abstract":"<div><h3>Background</h3><p>Anemia is common in the preoperative setting and associated with increased postoperative complications and mortality. However, it is unclear if preoperative anemia optimization reduces postoperative complications. We aimed to assess the association between preoperative anemia optimization and a composite endpoint of major cardiovascular, renal, and pulmonary complications and all-cause mortality within 30 days after noncardiac surgery in adult patients.</p></div><div><h3>Methods</h3><p>In this retrospective analysis preoperative anemia was defined as hemoglobin concentration below 12.0 g.dl<sup>−1</sup> in women and 13.0 g.dl<sup>−1</sup> in men within 6 months before surgery. A propensity score-based generalized estimating equation analysis was used to determine the association between preoperative anemia optimization and the primary outcome. Moreover, mediation analysis was conducted to investigate whether intraoperative red blood cell transfusion or duration of intraoperative hypotension were mediators of the relation between anemia optimization and the primary outcome.</p></div><div><h3>Results</h3><p>Fifty-seven hundred anemia optimized, and 8721 non-optimized patients met study criteria. The proportion of patients having any component of the composite of major complications and all-cause mortality was 21.5% in the anemia-optimized versus 18.0% in the non-optimized, with confounder-adjusted odds ratio estimate of 0.99 (95% CI 0.86‒1.15) for anemia optimization versus non-optimization, <em>p</em> = 0.90. Intraoperative red blood cell transfusion had a minor mediation effect on the relationship between preoperative anemia optimization and the primary outcome, whereas duration of intraoperative hypotension was not found to be a mediator.</p></div><div><h3>Conclusion</h3><p>Preoperative anemia optimization did not appear to be associated with a composite outcome of major in-hospital postoperative cardiovascular, renal, and pulmonary complications and all-cause in-hospital mortality.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001423001197/pdfft?md5=8a7788186706229fc5c54c789b30f5d7&pid=1-s2.0-S0104001423001197-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138479700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Infraclavicular versus costoclavicular approaches to ultrasound-guided brachial plexus block: a systematic review and meta-analysis 超声引导下锁骨下与肋锁下臂丛阻滞的比较:一项系统综述和荟萃分析。
IF 1.3 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-03-01 DOI: 10.1016/j.bjane.2023.09.004
Sara Amaral , Rafael Lombardi , Natalia Drabovski , Jeff Gadsden
{"title":"Infraclavicular versus costoclavicular approaches to ultrasound-guided brachial plexus block: a systematic review and meta-analysis","authors":"Sara Amaral ,&nbsp;Rafael Lombardi ,&nbsp;Natalia Drabovski ,&nbsp;Jeff Gadsden","doi":"10.1016/j.bjane.2023.09.004","DOIUrl":"10.1016/j.bjane.2023.09.004","url":null,"abstract":"<div><h3>Background</h3><p>The costoclavicular approach to brachial plexus block may have a more favorable anatomy than the classic infraclavicular approach. However, there are conflicting results in the literature regarding the comparative effectiveness of these two techniques.</p></div><div><h3>Methods</h3><p>We systematically searched for Randomized Controlled Trials (RCTs) comparing costoclavicular with infraclavicular brachial plexus blocks for upper extremity surgeries on MEDLINE, EMBASE, and Ovid. The outcomes of interest were sensory and motor block onset times, performance times, block failure, and complication rate. We performed statistical analyses using RevMan 5.4 and assessed heterogeneity using the Cochran Q test and I<sup>2</sup> statistics. We appraised the risk of bias according to Cochrane's Risk of Bias 2 tool.</p></div><div><h3>Results</h3><p>We included 5 RCTs and 374 patients, of whom 189 (50.5%) were randomized to undergo costoclavicular block. We found no statistically significant differences between the two techniques regarding sensory block onset time in minutes (Mean Difference [MD = -0.39 min]; 95% CI -2.46 to 1.68 min; <em>p</em> = 0.71); motor block onset time in minutes (MD = -0.34 min; 95% CI -0.90 to 0.22 min; <em>p</em> = 0.23); performance time in minutes (MD = -0.12 min; 95% CI -0.89 to 0.64 min; <em>p</em> = 0.75); incidence of block failure (RR = 1.59; 95% CI 0.63 to 3.39; <em>p</em> = 0.63); and incidence of complications (RR = 0.60; 95% CI 0.20 to 1.84; <em>p</em> = 0.37).</p></div><div><h3>Conclusion</h3><p>This meta-analysis suggests that the CCV block may exhibit similar sensory and motor onset times when compared to the classic ICV approach in adults undergoing distal upper extremity surgery, with comparable rates of block failure and complications.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001423000994/pdfft?md5=45930b8648ef4cffd6728a9bcbe77438&pid=1-s2.0-S0104001423000994-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41168958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Improving perioperative care in low-resource settings with goal-directed therapy: a narrative review 以目标为导向的治疗改善低资源环境下的围手术期护理:叙述性综述。
IF 1.3 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-03-01 DOI: 10.1016/j.bjane.2023.08.004
Suzana Margareth Lobo , João Manoel da Silva Junior , Luiz Marcelo Malbouisson
{"title":"Improving perioperative care in low-resource settings with goal-directed therapy: a narrative review","authors":"Suzana Margareth Lobo ,&nbsp;João Manoel da Silva Junior ,&nbsp;Luiz Marcelo Malbouisson","doi":"10.1016/j.bjane.2023.08.004","DOIUrl":"10.1016/j.bjane.2023.08.004","url":null,"abstract":"<div><p>Perioperative Goal-Directed Therapy (PGDT) has significantly showed to decrease complications and risk of death in high-risk patients according to numerous meta-analyses. The main goal of PGDT is to individualize the therapy with fluids, inotropes, and vasopressors, during and after surgery, according to patients’ needs in order to prevent organic dysfunction development. In this opinion paper we aimed to focus a discussion on possible alternatives to invasive hemodynamic monitoring in low resource settings.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001423000945/pdfft?md5=452c53fa393c724ea6e368be439ffb9b&pid=1-s2.0-S0104001423000945-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10121613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Methylene blue as an adjuvant during cardiopulmonary resuscitation: an experimental study in rats 亚甲蓝在大鼠心肺复苏过程中的辅助作用——一项实验研究。
IF 1.3 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-03-01 DOI: 10.1016/j.bjane.2023.10.003
Marcelo Souza Xavier, Matheus F. Vane, Roberta F. Vieira, Cristiano C. Oliveira, Debora R.R. Maia, Leticia U.C. de Castro, Maria José Carvalho Carmona, José Otávio Costa Auler Jr., Denise Aya Otsuki
{"title":"Methylene blue as an adjuvant during cardiopulmonary resuscitation: an experimental study in rats","authors":"Marcelo Souza Xavier,&nbsp;Matheus F. Vane,&nbsp;Roberta F. Vieira,&nbsp;Cristiano C. Oliveira,&nbsp;Debora R.R. Maia,&nbsp;Leticia U.C. de Castro,&nbsp;Maria José Carvalho Carmona,&nbsp;José Otávio Costa Auler Jr.,&nbsp;Denise Aya Otsuki","doi":"10.1016/j.bjane.2023.10.003","DOIUrl":"10.1016/j.bjane.2023.10.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Methylene Blue (MB) has been shown to attenuate oxidative, inflammatory, myocardial, and neurological lesions during ischemia-reperfusion and has great potential during cardiac arrest. This study aimed to determine the effects of MB combined with epinephrine during cardiac arrest on myocardial and cerebral lesions.</p></div><div><h3>Method</h3><p>Thirty-eight male Wistar rats were randomly assigned to four groups: the sham group (SH, n = 5), and three groups subjected to cardiac arrest (n = 11/group) and treated with EPI 20 µg.kg<sup>−1</sup> (EPI), EPI 20 µg.kg<sup>−1</sup> + MB 2 mg.kg<sup>−1</sup> (EPI + MB), or saline 0.9% 0.2 ml (CTL). Ventricular fibrillation was induced by direct electrical stimulation in the right ventricle for 3 minutes, and anoxia was maintained for 5 minutes. Cardiopulmonary Resuscitation (CPR) consisted of medications, ventilation, chest compressions, and defibrillation. After returning to spontaneous circulation, animals were observed for four hours. Blood gas, troponin, oxidative stress, histology, and TUNEL staining measurements were analyzed. Groups were compared using generalized estimating equations.</p></div><div><h3>Results</h3><p>No differences in the Returning of Spontaneous Circulation (ROSC) rate were observed among the groups (EPI: 63%, EPI + MB: 45%, CTL: 40%, <em>p</em> = 0.672). The mean arterial pressure immediately after ROSC was higher in the EPI+MB group than in the CTRL group (CTL: 30.5 [5.8], EPI: 63 [25.5], EPI+MB: 123 [31] mmHg, <em>p</em> = 0.007). Serum troponin levels were high in the CTL group (CTL: 130.1 [333.8], EPI: 3.70 [36.0], EPI + MB: 43.7 [116.31] ng/mL, <em>p</em> &lt; 0.05).</p></div><div><h3>Conclusion</h3><p>The coadministration of MB and epinephrine failed to yield enhancements in cardiac or brain lesions in a rodent model of cardiac arrest.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S010400142300115X/pdfft?md5=ebdad7c9e94f8df35568dd8764bb16b5&pid=1-s2.0-S010400142300115X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of the components of fluid balance in patients with septic shock: a prospective observational study 脓毒性休克患者体液平衡成分的评估:一项前瞻性观察研究。
IF 1.3 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-03-01 DOI: 10.1016/j.bjane.2024.844483
Maria Aparecida de Souza , Fernando José da Silva Ramos , Bianca Silva Svicero , Nathaly Fonseca Nunes , Rodrigo Camillo Cunha , Flavia Ribeiro Machado , Flavio Geraldo Rezende de Freitas
{"title":"Assessment of the components of fluid balance in patients with septic shock: a prospective observational study","authors":"Maria Aparecida de Souza ,&nbsp;Fernando José da Silva Ramos ,&nbsp;Bianca Silva Svicero ,&nbsp;Nathaly Fonseca Nunes ,&nbsp;Rodrigo Camillo Cunha ,&nbsp;Flavia Ribeiro Machado ,&nbsp;Flavio Geraldo Rezende de Freitas","doi":"10.1016/j.bjane.2024.844483","DOIUrl":"10.1016/j.bjane.2024.844483","url":null,"abstract":"<div><h3>Background</h3><p>The optimal amount for initial fluid resuscitation is still controversial in sepsis and the contribution of non-resuscitation fluids in fluid balance is unclear. We aimed to investigate the main components of fluid intake and fluid balance in both survivors and non-survivor patients with septic shock within the first 72 hours.</p></div><div><h3>Methods</h3><p>In this prospective observational study in two intensive care units, we recorded all fluids administered intravenously, orally, or enterally, and losses during specific time intervals from vasopressor initiation: T1 (up to 24 hours), T2 (24 to 48 hours) and T3 (48 to 72 hours). Logistic regression and a mathematical model assessed the association with mortality and the influence of severity of illness.</p></div><div><h3>Results</h3><p>We included 139 patients. The main components of fluid intake varied across different time intervals, with resuscitation and non-resuscitation fluids such as antimicrobials and maintenance fluids being significant contributors in T1 and nutritional therapy in T2/T3. A positive fluid balance both in T1 and T2 was associated with mortality (<em>p</em> = 0.049; <em>p</em> = 0.003), while nutritional support in T2 was associated with lower mortality (<em>p</em> = 0.040). The association with mortality was not explained by severity of illness scores.</p></div><div><h3>Conclusions</h3><p>Non-resuscitation fluids are major contributors to a positive fluid balance within the first 48 hours of resuscitation. A positive fluid balance in the first 24 and 48 hours seems to independently increase the risk of death, while higher amount of nutrition seems protective. This data might inform fluid stewardship strategies aiming to improve outcomes and minimize complications in sepsis.</p></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001424000058/pdfft?md5=78c5f68efea5e4550b3f99753c3a0190&pid=1-s2.0-S0104001424000058-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Primary ciliary dyskinesia: a case of complete Kartagener's syndrome in a patient undergoing cesarean section 原发性纤毛运动障碍:一例剖宫产患者的完全Kartagener综合征。
IF 1.3 4区 医学
Brazilian Journal of Anesthesiology Pub Date : 2024-03-01 DOI: 10.1016/j.bjane.2023.10.002
Paula Daniele Lopes da Costa , Thaiza Oliveira Marinho , Norma Sueli Pinheiro Módolo , Paulo do Nascimento Junior
{"title":"Primary ciliary dyskinesia: a case of complete Kartagener's syndrome in a patient undergoing cesarean section","authors":"Paula Daniele Lopes da Costa ,&nbsp;Thaiza Oliveira Marinho ,&nbsp;Norma Sueli Pinheiro Módolo ,&nbsp;Paulo do Nascimento Junior","doi":"10.1016/j.bjane.2023.10.002","DOIUrl":"10.1016/j.bjane.2023.10.002","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0104001423001148/pdfft?md5=68127f1f21ad9cad95510947e2210539&pid=1-s2.0-S0104001423001148-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49694777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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