Navegando por Palavras-chave "postoperative period"
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- ItemSomente MetadadadosAnalysis of Risk Factors for Extubation Failure in Subjects Submitted to Non-Emergency Elective Intracranial Surgery(Daedalus Enterprises Inc, 2012-12-01) Vidotto, Milena Carlos [UNIFESP]; Sogame, Luciana Carrupt Machado [UNIFESP]; Gazzotti, Mariana Rodrigues [UNIFESP]; Prandini, Mirto Nelson [UNIFESP]; Jardim, Jose Roberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Escola Super Ciencias Santa Casa Misericordia VitBACKGROUND: Extubation failure is defined as the re-institution of respiratory support ranging from 24 to 72 hours following scheduled extubation and occurs in 2% to 25% of extubated patients. the aim of this study was to determine clinical and surgical risk factors that may predict extubation failure in patients submitted to non-emergency intracranial surgery. METHODS: This was a prospective observational cohort study. the study was carried out on 317 subjects submitted to non-emergency intracranial surgery for tumors, aneurysms, and arteriovenous malformation. Preoperative assessment was performed and subjects were followed up for the determination of extubation failure until either discharge from hospital or death. RESULTS: Twenty-six (8.2%) of the 317 subjects experienced extubation failure following surgery. the following variables were considered for the multivariate analysis: level of consciousness at the time of extubation, duration of mechanical ventilation prior to extubation, sex and the use of intraoperative mannitol. the multivariate analysis determined that the most important variable for extubation failure was the level of consciousness at the time of extubation (P = .001), followed by female sex, which also showed to be significant (P = .006). CONCLUSIONS: Lower level of consciousness (GCS 8T-10T) and female sex were considered risk factors for extubation failure in subjects submitted to elective intracranial surgery.
- ItemAcesso aberto (Open Access)Parâmetros nutricionais pré-operatórios para pacientes após cirurgia bariátrica(Universidade Federal de São Paulo (UNIFESP), 2019) Jamil, Liliane Carvalho [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Surgical outcomes in post bariatric patients are strongly influenced by the patient's nutritional status. Despite the extensive literature, in practice, follow-up management and nutritional preparation for bariatric patients undergoing subsequent surgeries present great variation. There is a need to standardize and summarize post bariatric nutritional recommendations in order to optimize preparation of patients for following surgeries. Objective: To define the preoperative nutritional parameters for post bariatric patients and create an assessment tool based on the current recommendations. Method: A review of the literature was carried out in the Health Information databases of the National Library of Medicine (MEDLINE), the electronic library of the Electronic On-line Library (SciELO) in Latin American and Caribbean Literature in Health Sciences (LILACS and Embase from January 2008 to October 2018 with use of the following terms: bariatric surgery, nutritional status, trace elements, nutritional physiological phenomena, postoperative care, postoperative period. The agreement between two examiners was evaluated using the Kappa coefficient. The content of the selected articles was submitted to the thematic analysis. Recommendations found in this review were organized to create an assessment tool. Results: Recommendations regarding routine testing, prophylactic and therapeutic supplementation and multidisciplinary follow-up for post-bariatric patients were identified in the literature. Conclusion: Preoperative nutritional parameters for post bariatric patients were defined and organized in an assessment tool.
- ItemSomente MetadadadosVital capacity reduction in postoperative of elective craniotomy(Revista De Neurologia, 2008-08-01) Gazzotti, Mariana Rodrigues [UNIFESP]; Vidotto, Milena Carlos [UNIFESP]; Sogame, Luciana Carrupt Machado [UNIFESP]; Hayashi, Lucas Yutaka; Jardim, José Roberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); EMESCAMAims. To assess the vital capacity (VC), tidal volume, minute volume and respiratory rate during the first four postoperative days of elective craniotomy and how they are correlated with smoking , associated diseases and respiratory symptoms. Patients and methods. Ninety-four patients were initially evaluated for elective craniotomy and they were included in this study only if they presented normal consciousness level and spontaneous breathing at the first postoperative. The preoperative and postoperative evaluations comprised physical examination and ventilometry up to the fourth postoperative. The repeated measures analysis of variance was used to the ventilation measurements. The significance level adopted for all the statistical tests was p = 0.05. Results. Sixty-two patients were included in this study. There was a 20% fall in the VC from the first to the third postoperative (p = 0.001). Patients with systemic arterial hypertension presented in the preoperative period a lower mean VC (2.59 L) than the patients without (3.28 L) (p = 0.045). Smokers presented a lower mean VC (2.65 and 1.95 L) than the nonsmokers (3.13 and 2.43 L), both in the preoperative and in the postoperative, but with no statistic significance (p = 0.090). Conclusion. After elective craniotomy, there is a significant decrease in VC immediately after surgery, improving gradually thereafter; there was no different in VC between the smoking and nonsmoking patients in the pre- and postoperative as well.