Revista do Colégio Brasileiro de Cirurgiões
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Randomized Controlled Trial Comparative Study
Curative ablation of atrial fibrillation: comparison between deep sedation and general anesthesia.
To compare deep sedation with general anesthesia for curative ablation of atrial fibrillation. ⋯ Both techniques can be used for the curative ablation of atrial fibrillation. General anesthesia provided smaller respiratory changes and greater immobility of the patient.
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Traumatic brain injury (TBI) with associated intracranial hemorrhage (ICH) occurs frequently in trauma. Trauma patients are also at high risk of developing venous thromboembolic (VTE) complications. Low Molecular Weight Heparin (LMWH) is used in trauma patients as prophylaxis to reduce the risk of VTE events. ⋯ Much of this research, however, was generated by a single center and consequently lacks external validity. Furthermore, clinical recommendations cannot be generated based on pilot studies. Evidence-based guidelines and recommendations could not be made at this time, until the completion of further studies on this challenging topic.
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Observational Study
Procalcitonin as a prognostic biomarker of severe sepsis and septic shock.
To evaluate the tendency of the plasma concentration and clearance of procalcitonin (PCT-c) as biomarkers of prognosis of patients with severe sepsis and septic shock, compared to another early prognosis marker, the number of SIRS criteria at sepsis diagnosis. ⋯ Persistently high procalcitonin concentrations in plasma, as well as reduced 24-hours PCT clearence, were associated with a significant increase in mortality in patients with severe sepsis and septic shock.
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To determine the correlation of Gram staining with the culture of bronchoalveolar lavage in patients with clinical features of ventilator-associated pneumonia from two adult trauma and surgical intensive care units. ⋯ It appears that the negative predictive value for Gram-positive cocci is acceptable, but the sensitivity of Gram staining in the etiology of ventilator-associated pneumonia was not able to identify the microorganism before culture.
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To analyze the results after the implementation of the non-operative management (NOM) of the right upper thoracoabdominal gunshot injuries protocol. ⋯ NOM of the penetrating right thoracoabdominal injuries must be seen with caution. The NOM of right thoracoabdominal gunshot injuries is safe only in selected cases, followed by well-defined protocols and when performed in places that have adequate infrastructure.