ADRIANO ROGERIO BALDACIN RODRIGUES
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
5 resultados
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- Factors associated with reoperation due to bleeding and outcomes after cardiac surgery: a prospective cohort study(2022) RODRIGUES, Adriano Rogerio Baldacin; BENEVIDES, Luana Maria Braz; CRESPO, Jeiel Carlos Lamonica; SANTANA-SANTOS, Eduesley; PUSCHEL, Vilanice Alves de Araujo; OLIVEIRA, Larissa Bertacchini deObjective: Identify the incidence and factors associated with reoperation due to bleeding in the postoperative of a cardiac surgery, in addition to the clinical outcomes of patients. Method: Prospective cohort study, conducted in an Intensive Care Unit (ICU), with adult patients undergoing cardiac surgery. Patients diagnosed with coagulopathies were excluded. The patients were followed up from hospitalization to hospital discharge. Results: A total of 682 patients were included, and the incidence of reoperation was 3.4%. The factors associated with reoperation were history of renal failure (p = 0.005), previous use of anticoagulant (p = 0.036), higher intraoperative heart rate (p = 0.015), need for transfusion of blood component during intraoperative (p = 0.040), and higher SAPS 3 score (p < 0.001). The outcomes associated with reoperation were stroke and cardiac arrest. Conclus??o: Reoperation was an event associated with greater severity, organic dysfunction, and worse clinical outcomes, but there was no difference in mortality between the groups.
- Factors associated with the increased bleeding in the postoperative period of cardiac surgery: A cohort study(2019) PEREIRA, Karla M. F. S. M.; ASSIS, Caroline S. de; CINTRA, Haulcionne N. W. L.; FERRETTI-REBUSTINI, Renata Eloah L.; PUESCHEL, Vilanice A. A.; SANTANA-SANTOS, Eduesley; RODRIGUES, Adriano Rogerio B.; OLIVEIRA, Larissa B. deAims and objectives To identify factors associated with the increased bleeding in patients during the postoperative period after cardiac surgery. Background Bleeding is among the most frequent complications that occur in the postoperative period after cardiac surgery, representing one of the major factors in morbidity and mortality. Understanding the factors associated with the increased bleeding may allow nurses to anticipate and prioritise care, thus reducing the mortality associated with this complication. Design Prospective cohort study. Methods Adult patients in a cardiac hospital who were in the postoperative period following cardiac surgery were included. Factors associated with the increased bleeding were investigated by means of linear regression, considering time intervals of 6 and 12 hr. Results The sample comprised 391 participants. The factors associated with the increased bleeding in the first 6 hr were male sex, body mass index, cardiopulmonary bypass duration, anoxia duration, metabolic acidosis, higher heart rate, platelets and the activated partial thromboplastin time in the postoperative period. Predictors in the first 12 hr were body mass index, cardiopulmonary bypass duration, metabolic acidosis, higher heart rate, platelets and the activated partial thromboplastin time in the postoperative. Conclusions This study identified factors associated with the increased postoperative bleeding from cardiac surgery that have not been reported in previous studies. The nurse is important in the vigilance, evaluation and registry of chest tube drainage and modifiable factors associated with the increased bleeding, such as metabolic acidosis and postoperative heart rate, and in discussions with the multiprofessional team. Relevance to clinical practice Knowledge of the factors associated with the increased bleeding is critical for nurses so they can provide prophylactic interventions and early postoperative treatment when needed.
- Estratégias de prevenção da lesão renal aguda em cirurgia cardíaca: revisão integrativa(2014) SANTANA-SANTOS, Eduesley; MARCUSSO, Marila Eduara Fátima; RODRIGUES, Amanda Oliveira; QUEIROZ, Fernanda Gomes de; OLIVEIRA, Larissa Bertacchini de; RODRIGUES, Adriano Rogério Baldacin; PALOMO, Jurema da Silva HerbasAcute kidney injury is a common complication after cardiac surgery and is associated with increased morbidity and mortality and increased length of stay in the intensive care unit. Considering the high prevalence of acute kidney injury and its association with worsened prognosis, the development of strategies for renal protection in hospitals is essential to reduce the associated high morbidity and mortality, especially for patients at high risk of developing acute kidney injury, such as patients who undergo cardiac surgery. This integrative review sought to assess the evidence available in the literature regarding the most effective interventions for the prevention of acute kidney injury in patients undergoing cardiac surgery. To select the articles, we used the CINAHL and MedLine databases. The sample of this review consisted of 16 articles. After analyzing the articles included in the review, the results of the studies showed that only hydration with saline has noteworthy results in the prevention of acute kidney injury. The other strategies are controversial and require further research to prove their effectiveness.
- High levels of B-type natriuretic peptide predict weaning failure from mechanical ventilation in adult patients after cardiac surgery(2013) LARA, Thiago Martins; HAJJAR, Ludhmila Abrahao; ALMEIDA, Juliano Pinheiro de; FUKUSHIMA, Julia Tizue; BARBAS, Carmem Silvia Valente; RODRIGUES, Adriano Rogerio Baldacin; NOZAWA, Emilia; FELTRIM, Maria Ignes Zanetti; ALMEIDA, Elisangela; COIMBRA, Vera; OSAWA, Eduardo; IANOTTI, Rafael de Moraes; LEME, Alcino Costa; JATENE, Fabio Biscegli; AULER- JR., Jose Otavio Costa; GALAS, Filomena Regina Barbosa GomesOBJECTIVE: The failure to wean from mechanical ventilation is related to worse outcomes after cardiac surgery. The aim of this study was to evaluate whether the serum level of B-type natriuretic peptide is a predictor of weaning failure from mechanical ventilation after cardiac surgery. METHODS: We conducted a prospective, observational cohort study of 101 patients who underwent on-pump coronary artery bypass grafting. B-type natriuretic peptide was measured postoperatively after intensive care unit admission and at the end of a 60-min spontaneous breathing test. The demographic data, hemodynamic and respiratory parameters, fluid balance, need for vasopressor or inotropic support, and length of the intensive care unit and hospital stays were recorded. Weaning failure was considered as either the inability to sustain spontaneous breathing after 60 min or the need for reintubation within 48 h. RESULTS: Of the 101 patients studied, 12 patients failed the weaning trial. There were no differences between the groups in the baseline or intraoperative characteristics, including left ventricular function, EuroSCORE and lengths of the cardiac procedure and cardiopulmonary bypass. The B-type natriuretic peptide levels were significantly higher at intensive care unit admission and at the end of the breathing test in the patients with weaning failure compared with the patients who were successfully weaned. In a multivariate model, a high B-type natriuretic peptide level at the end of a spontaneous breathing trial was the only independent predictor of weaning failure from mechanical ventilation. CONCLUSIONS: A high B-type natriuretic peptide level is a predictive factor for the failure to wean from mechanical ventilation after cardiac surgery. These findings suggest that optimizing ventricular function should be a goal during the perioperative period.
- Assessment of workload in the postoperative period of cardiac surgery according to the Nursing Activities Score(2015) OLIVEIRA, Larissa Bertacchini de; RODRIGUES, Adriano Rogerio Baldacin; PUESCHEL, Vilanice Alves de Araujo; SILVA, Fernanda Aparecida da; CONCEICAO, Suellen Lopes da; BEDA, Laisla Baccarin; FIDELIS, Bruna; SANTANA-SANTOS, Eduesley; SECOLI, Silvia ReginaObjective: Identify factors associated with the workload of nursing care for patients in the postoperative period of cardiac surgery. Method: Prospective cohort study conducted with 187 patients in the surgical intensive care unit (ICU) of the Instituto do Coracao (Heart Institute) in Sao Paulo-Brazil. Data were collected at 24 and 72 hours of the patients' admittance in the ICU. The dependent variable was workload as calculated by the Nursing Activities Score (NAS). The independent variables were demographic and clinical, as well as mortality scores. For data analysis, the Wilcoxon-Mann-Whitney test and Spearman correlation were used, and linear regression with mixed effects model. Results: The majority of patients were male (59.4%), with a mean age of 61 years (+/- 12.7), and 43.9% developed some kind of complication in the postoperative period. In the first 24 hours, the workload was 82.4% (+/- 3.4), and 58.1% (+/- 3.4) in 72 hours. Factors associated with increased NAS were: patient's length of stay in the ICU (p=0.036) and the presence of complications (p<0.001). Conclusion: In contrast to numerous other studies, the severity of the patient's condition in the first 24 hours of the postoperative period did not increase workload, the increase was associated with length of stay in the ICU and complications.