Cardiovascular disease has been the leading cause of mortality worldwide. In Brazil, the AMI has had great relevance, increasing the number of cardiac surgery, especially CABG. This procedure is responsible for reductions in lung volume and capacity, and reduce respiratory muscle strength, contributing to the increased incidence of postoperative complications, and when risk factors associated with medical and surgical, prolong hospital stay the patient. Physical therapy is part of the multidisciplinary team and their role is to prevent or treat respiratory complications, from weaning to maintain the patient in spontaneous ventilation after extubation. This study aims to point out the physical therapy techniques that have been used in patient care in postoperative coronary artery bypass grafting, noting its effectiveness against major injuries lung affected by this type of procedure, and clarify the effects physiotherapy in major pulmonary complications in this period. We searched randomized studies, published between 2002 to 2012, the databases LILACS, SCIELO, PEDRO and CAPES. Most articles have found positive responses to pipelines applied physiotherapy, physiotherapist as confirming the essential professional care to patients of coronary artery bypass grafting.

https://repositorio.bahiana.edu.br:8443/jspui/bitstream/bahiana/602/1/Disserta%c3%a7%c3%a3o.Santos.GiseleAssisdeOliveira.2012.001.BAHIANA.pdf

FISIOTERAPIA NAS COMPLICAÇÕES PULMONARES NO PÓS-OPERATÓRIO DE CIRURGIA DE REVASCULARIZAÇÃO DO MIOCÁRDIO Salvador

The persistence of the fourth right aortic arch (PRAA) is a congenital malformation that affects the heart base’s main vessels. Surgical treatment is recommended and should be advocated as a matter of urgency. In this context, efficient anesthesia planning is necessary, with satisfactory analgesia, associating multimodal techniques with regional blocks. The present work aims to report the anesthetic procedure during corrective surgery for PRAA in a dog. Neuroleptanalgesia was intramuscularly performed, using acepromazine (0.015 mg.kg-1) and methadone (0.3 mg.kg-1) in pre-anesthetic medication. Ketamine (1 mg.kg-1) and propofol (3 mg.kg-1) were administered at induction, both intravenously, followed by maintenance using total intravenous anesthesia with propofol (initial rate of 0.4 mg.kg-1 .minute) and remifentanil, (0.2 mcg.kg.-1.minute). In addition, ultrasound-guided regional intercostal block was performed, with 5% bupivacaine without vasoconstrictor (0.05ml.kg-1). Ketamine infusion was postoperatively maintained for one hour. The instituted protocol proved to be satisfactory in controlling trans and postoperative pain, maintaining all parameters stable during and after the procedure, without any intercurrence. Thus, the protocol provided quality recovery to the patient.

https://periodicos.ufersa.edu.br/index.php/acta/article/download/10265/10840

Multimodal anesthesia associated with regional block in a dog who underwent corrective surgery for persistent right aortic arch: case report

SUMMARY Castellana FB, Malbouisson LMS, Carmona MJC, Lopes CR,Auler Jr JOC - Comparison between Pressure Controlled andControlled Mandatory Ventilation in the Treatment of Postope-rative Hypoxemia after Myocardial Revascularization BACKGROUND AND OBJECTIVES: Pressure controlled ven-tilation (PCV) has been used as the ventilation mode of choicein coronary artery bypass graft surgery patients who developseverehypoxemiaintheimmediatepostoperativeperiod.How-ever, there are no evidences showing that pressure controlledventilation is more effective in reversing postoperativehypoxemia than controlled mandatory ventilation (CMV). Thisstudy aimed at comparing the effects of both ventilation modeson systemic oxygenation in cardiac surgery patients who de-velop hypoxemia characterized by PaO 2 /FiO 2 ratio lower than200 in the immediate postoperative period. METHODS: Participated in this study 61 consecutive patientswith PaO 2 /FiO 2 ratio lower than 200 who were randomly allo-cated in two groups according to the ventilatory mode (CMVand PCV). Tidal volume, respiratory rate, inspiration/expirationratio and positive end-expiratory pressure were kept constantthroughout the study in both groups. PaO

Comparação entre Ventilação Controlada a Volume e a Pressão no Tratamento da Hipoxemia no Período Pós-Operatório de Cirurgia de Revascularização do Miocárdio * Comparison between Pressure Controlled and Controlled Mandatory Ventilation in the Treatment of Postoperative Hypoxemia after Myocardial Revascularization

Several scores for predicting morbidity and mortality in patients undergoing surgery, who will possibly use ICU beds, are being tested. Currently, the indication of intensive postoperative support for elective surgeries is established in a subjective way and may even endanger the performance of the hospital since it could spawn the suspension of operations due to lack of vacancies in the ICU. The most used score was proposed by the American Society of Anesthesiologists, ASA, as a risk predictor, however this classification is frequently submitted to different interpretations. It is also considered the use of POSSUM, which takes into account twelve physiological variables and six surgical variables. We could mention the Karnofsky scale as well, which classify patients according to the degree of functional disability caused by a neoplastic disease. The objective of this study was to correlate these elements in order to find a better predictor for ICU. Secondly, we intended to verify whether POSSUM physiological variables could be used as predictors to ICU reservation in surgeries. We reviewed 186 patients medical records undergoing oncologic surgeries. As a result, we can infer that the physiological variables that compose the POSSUM are more accurate as predictors than all the other analysed elements that could also predict bed reservation in ICU. Moreover, we may notice that the POSSUM variables age, serum hemoglobin and systolic blood pressure would be sufficient to predict properly the vacancy allocation in the ICU.

/pdf/modelo-para-predicao-de-morbi-mortalidade-e-de-necessidade-46yzrltufy.pdf

Modelo para predição de morbi-mortalidade e de necessidade de UTI pós-operatória em pacientes cirúrgicos oncológicos Model for predicting morbidity and mortality and need for ICU post- operative surgical patients with cancer

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Modelo para predição de morbi-mortalidade e de necessidade de UTI pós-operatória em pacientes cirúrgicos oncológicos Model for predicting morbidity and mortality and need for ICU post- operative surgical patients with cancer