Revista brasileira de anestesiologia
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Outcome in intensive care can be categorized as mortality related or morbidity related. Mortality is an insufficient measure of ICU outcome when measured alone and length of stay may be seen as an indirect measure of morbidity related outcome. The aim of the present study was to estimate the incidence and predictive factors for intrahospitalar outcome measured by mortality and LOS in patients admitted to a surgical ICU. ⋯ In conclusion, prolonged ICU stay is more frequent in more severely ill patients at admission and it is associated with higher hospital mortality. Hospital mortality is also more frequent in patients submitted to emergent and major surgery.
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Rev Bras Anestesiol · Feb 2006
[The lateral midfemoral approach to sciatic nerve block as an anesthetic option to trauma: case repor t.].
Both nervous plexus block and isolated peripheral nerve block are uncommon procedures for patients with lower limb trauma or full stomach, prevailing epidural and spinal blocks as the primary indication. This case report describes the choice of sciatic nerve block as the best indication for a patient with full stomach and severe foot trauma. ⋯ Lateral midfemoral sciatic nerve block as anesthetic option for foot trauma was based on pre-established criteria, such as the preference for regional anesthesia in patients with full stomach and candidates to urgency limb procedures, postural limitation of patients to perform some techniques, such as spinal procedures, anatomic understanding of somatic limb innervation and the mastering of alternative regional techniques.
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Management of hemostasis of cardiopulmonary bypass (CPB) patients is still a major challenge. New monitoring methods, new hemostatic drugs and new platelet function inhibitors are being added to the pre, intra and postoperative periods. The multifactorial nature of CBP-induced hemostasis disorders requires the understanding of their pathophysiology and the accurate hemostasis evaluation for effective coagulation during CPB, in addition to the maintenance of adequate postoperative hemostasis. Activated clotting time (ACT) and coagulogram are not enough for this management. A broader evaluation is needed with monitors able to measure platelet function and hemostatic process dynamics as a whole. ⋯ Thromboelastograph is an important hemostasis monitor for patients submitted to CPB. It has been incorporated to hemostatic disorders evaluation protocols and transfusion therapy, with good results.