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  2. Palavra-chave: Postoperative Care
IJCS
Original Article

Transfusion of Blood Products in the Postoperative of Cardiac Surgery

Antonieta Moraes et al. Juliana Neves Giordani Cristiane Tavares Borges Pauline Eloise Mariani … Laura Maggi da Costa Leonardo Hennig Bridi Ari Tadeu Lirio dos Santos Renato Kalil

Abstract

Background:

The indiscriminate use of blood transfusion in surgery has been associated with increased risk of infection and increased length of hospital stay.

Objective:

To identify the average amount of bleeding and rates of transfusion of blood products in the postoperative period of patients undergoing cardiac surgery in a cardiology center.

Methods:

Medical records of patients who underwent myocardial revascularization surgery and/or heart valve replacement with use of cardiopulmonary bypass (CPB) were analyzed. Perioperative data such as CPB time, hematocrit and hemoglobin values were collected after surgery. The amount of bleeding (mL), blood transfusion (IU), clinical complications and time of hospitalization were also recorded. The correlation between bleeding in the postoperative period and blood transfusion was performed using the Spearman correlation. A p < 0.05 was considered statistically significant.

Results:

A total of 423 patients undergoing coronary artery bypass grafting (51.5%) or heart valve replacement (33.6%) were included. During the first 24 hours, the average bleeding volume was 353.3 ± 268.3 mL. Transfusion of blood products was required in 40.1% of cases, most frequently (70.6%) in the immediate postoperative period. Red blood cell concentrate was the most frequently used product (22.9% and 60%).

Conclusion:

The occurrence of bleeding in the cases was low, and when transfusion of blood components was indicated, red blood cell concentrates were the most widely used component. (Int J Cardiovasc Sci. 2021; [online].ahead print, PP.0-0)

  • Blood Transfusion/methods
  • Cardiac Surgery
  • Postoperative Care
  • Transfusion Reaction/complications
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Creative Commons Attribution (CC BY) Creative Commons license
30/04/2021 DOI: 10.36660/ijcs.20190192 Visualizações 1
IJCS
Original Article

Correlation between Surgical Risk Scales with Respiratory Muscle Strength and Functional Independence in Patients Submitted to Coronary Artery Bypass Grafting

André Luiz Lisboa Cordeiro et al. Átila Darlan Queiroz de Brito Graziele Freitas Almeida Leilane Souza Jesus … Flávia de Araújo Oliveira Janinne Lima da Silva André Raimundo França Guimarães Roberto Moreno Barros

Abstract

Background

The European Heart Surgery Risk Assessment System (EuroSCORE) and InsCor have been used to predict complications of cardiac surgery. However, their application to predict lung function and functionality is still uncertain.

Objective

To correlate surgical risk scales with functional independence and pulmonary function in patients undergoing coronary artery bypass grafting.

Methods

This was a prospective cohort study. In the preoperative period, the two surgical scales were applied, the maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and peak expiratory flow (PEF) were measured, and functionality was assessed using the functional independence measure (FIM). On the seventh postoperative day, the pulmonary function and functionality variables were reevaluated, compared with the preoperative values (delta) and correlated with the risk scales. Correlations of pulmonary function, functional independence and muscle strength variables with the surgical scales were made by Pearson correlation test. The significance level adopted was 5%.

Results

Thirty-one patients were studied; most were male (77%), with a mean age of 56±8 years. Mean EuroSCORE was 2.3±0.5 and mean InsCOR was 1.2±0.5. MIP, MEP, and PEF reduced 30% (p<0.001), 33% (p<0.001) and 10% (p=0.23), respectively. The EuroSCORE correlated with MIP (r-0.78; p = 0.02) and FIM (r-0.79; p <0.01), and the InsCor correlated with MIP (r-0.77), MEP (r-0.73) and MIF (r-0.89; p=0.02).

Conclusion

The EuroSCORE showed a strong negative correlation with MIP and FIM, while InsCor had a strong negative correlation with MIP, MEP and FIM. (Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0)

  • Cardiovascular Diseases, mortality
  • Muscle Stremght
  • Myocardial revascularization
  • Physical Therapy Speciality
  • Postoperative Care
  • Pre-Operative Care
  • Respiratory Pressures
  • Risk Assessment
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Creative Commons Attribution (CC BY) Creative Commons license
15/07/2020 DOI: 10.36660/ijcs.20190161 Visualizações 1
IJCS
Editorial

Pain after Cardiac Surgery

Tirone E. David

Most cardiac operations are performed via median sternotomy and cardiopulmonary bypass. Both thoracic incision and cardiopulmonary bypass cause major disturbances in the homeostasis of the patient. Disruption of the tissues by the incision initiates an immediate neurological reaction perceived as pain and an intense biochemical and cellular response to repair the wound. Cardiopulmonary bypass causes far more serious systemic changes in homeostasis than pain, and that is probably the main reason why cardiac surgery is behind other surgical specialties in the development of minimally invasive procedures. Pain associated with surgical incision is largely self-limited and resolves with time and, luckily, so do the changes caused by cardiopulmonary bypass. Obviously, surgical incisions that cause less tissue damage are associated with lower degrees of pain and metabolic disturbance than larger and more traumatic incisions.

In this issue of the International Journal of Cardiovascular Sciences, Silva and colleagues, from the University of Fortaleza, Brazil, report a comparative study on postoperative pain following conventional median sternotomy and right mini-thoracotomy. The study has limitations because of the sample size (there were only 17 patients in each arm), the endpoint of the study was largely subjective, and patients were not randomized. However, as one would expect, both groups of patients complained of pain in the first three days but fewer patients with mini-thoracotomy complained of pain by the seventh postoperative day. In addition, mini-thoracotomy was associated with pain of lower intensity, fewer sites, and shorter duration than median sternotomy.

[…]

  • Cardiovascular Surgical Procedures
  • Minimally Invasive Surgical Procedures
  • Postoperative Care
  • sternotomy
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Creative Commons Attribution (CC BY) Creative Commons license
17/02/2020 DOI: 10.36660/ijcs.20190188 Visualizações 1
IJCS
Original Article

Minimally Invasive Cardiac Surgery versus Sternotomy – Pain Investigation

Juliana Fernandes Silva et al. Marcela Paula Cavalcante Roger Benevides Montenegro Romulo Lira … Emanuel Carvalho Mel Josue Viana Castro

Abstract

Background:

Treatment of postoperative (PO) pain is essential after surgery, as it contributes to a faster rehabilitation. Assessment of PO pain after minimally invasive (MI) surgery has not been regularly addressed, especially when compared with median sternotomy (MS).

Objective:

This study aims to evaluate the intensity of thoracic pain in the PO period in patients subjected to MI surgery and MS.

Methods:

This study compared the intensity of thoracic pain in 34 patients subjected to minimally invasive (MI; n = 17) and median sternotomy (MS; n = 17) from June 2015 to June 2016. The intensity and sites of pain in the PO period, assessed using the visual numeric pain scale, and the need for pain medications were analyzed using the Student’s t-test and the z test, with confidence level of 95% (p < 0.05).

Results:

Almost all patients reported pain on the third PO day (MS = 94.1% and MI = 88.2%; p = 0.5410). On the seventh PO day, there were significantly more patients free of pain in the group of patients subjected to the MI procedure (MS = 94.1% and MI = 64.7%; p = 0.0341). also, these patients reported fewer pain sites (3rd PO day: MS = 3.2 ± 1.5; MI = 1.5 ± 1.2; p = 0.001; 7th PO day: MS = 3.1 ± 1.4; MI = 0.9 ± 0.9; p = 0.000). Patients undergoing MS reported higher pain intensity and longer lasting pain (3rd PO: MS = 4.8 ± 2.2; MI = 3.0 ± 1.6; 7th PO: MS = 5.3 ± 2.0; MI = 1.2 ± 1.3; p = 0.001), with no difference in pain intensity between the third and the seventh PO days (p = 0.4931). In addition, patients subjected to MI procedure had a significant decrease in pain intensity from the third to the seventh PO days (p = 0.001).

Conclusion:

According to these results, we concluded that a MI procedure leads to lower intensity of pain in the PO period (from the third PO day on) when compared to a MS; also, patients undergoing MI patients reported fewer pain sites.

  • Cardiovascular Surgical Procedures
  • Minimally Invasive Surgical Procedures
  • Postoperative Care
  • sternotomy
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Creative Commons Attribution (CC BY) Creative Commons license
19/08/2019 DOI: 10.5935/2359-4802.20190048 Visualizações 1

Como citar este artigo

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

Moraes A, Giordani JN, Borges CT, Mariani PE, Costa LM, Bridi LH, Santos ATL, et al. Transfusion of Blood Products in the Postoperative of Cardiac Surgery. International Journal of Cardiovascular Sciences 2021;34(5):499-505.

Formato de Documento Eletrônico (ABNT)

Moraes, Antonieta; Giordani, Juliana Neves; Borges, Cristiane Tavares; Mariani, Pauline Eloise; Costa, Laura Maggi da; Bridi, Leonardo Hennig; Santos, Ari Tadeu Lirio dos; Kalil, Renato. Transfusion of Blood Products in the Postoperative of Cardiac Surgery. International Journal of Cardiovascular Sciences, v. 34, n. 5, p. 499-505, abr. 2021.

Formato de Documento Eletrônico (APA)

Moraes, A., Giordani, J. N., Borges, C. T., Mariani, P. E., Costa, L. M. , Bridi, L. H., Santos, A. T. L. , & Kalil, R. (2021). Transfusion of Blood Products in the Postoperative of Cardiac Surgery. International Journal of Cardiovascular Sciences, 34(5), 499-505.

Formato de Documento Eletrônico (ISO)

Moraes, Antonieta and Giordani, Juliana Neves and Borges, Cristiane Tavares and Mariani, Pauline Eloise and Costa, Laura Maggi da and Bridi, Leonardo Hennig and Santos, Ari Tadeu Lirio dos and Kalil, Renato. Transfusion of Blood Products in the Postoperative of Cardiac Surgery. International Journal of Cardiovascular Sciences [online]. 2021, vol. 34, n. 5, [citado 2026-10-14], pp. 499-505. Disponível em: <https://journals.cardiol.br/article/transfusion-of-blood-products-in-the-postoperative-of-cardiac-surgery-2/>. ISSN 2359-4802

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

Cordeiro ALL, Brito DQ, Almeida GF, Jesus LS, Oliveira FA, Silva JL, Guimarães ARF, et al. Correlation between Surgical Risk Scales with Respiratory Muscle Strength and Functional Independence in Patients Submitted to Coronary Artery Bypass Grafting. International Journal of Cardiovascular Sciences 2020;34(1):60-6.

Formato de Documento Eletrônico (ABNT)

Cordeiro, André Luiz Lisboa; Brito, Átila Darlan Queiroz de; Almeida, Graziele Freitas; Jesus, Leilane Souza; Oliveira, Flávia de Araújo; Silva, Janinne Lima da; Guimarães, André Raimundo França; Barros, Roberto Moreno. Correlation between Surgical Risk Scales with Respiratory Muscle Strength and Functional Independence in Patients Submitted to Coronary Artery Bypass Grafting. International Journal of Cardiovascular Sciences, v. 34, n. 1, p. 60-66, jul. 2020.

Formato de Documento Eletrônico (APA)

Cordeiro, A. L. L., Brito, D. Q. , Almeida, G. F., Jesus, L. S., Oliveira, F. A., Silva, J. L. , Guimarães, A. R. F., & Barros, R. M. (2020). Correlation between Surgical Risk Scales with Respiratory Muscle Strength and Functional Independence in Patients Submitted to Coronary Artery Bypass Grafting. International Journal of Cardiovascular Sciences, 34(1), 60-66.

Formato de Documento Eletrônico (ISO)

Cordeiro, André Luiz Lisboa and Brito, Átila Darlan Queiroz de and Almeida, Graziele Freitas and Jesus, Leilane Souza and Oliveira, Flávia de Araújo and Silva, Janinne Lima da and Guimarães, André Raimundo França and Barros, Roberto Moreno. Correlation between Surgical Risk Scales with Respiratory Muscle Strength and Functional Independence in Patients Submitted to Coronary Artery Bypass Grafting. International Journal of Cardiovascular Sciences [online]. 2020, vol. 34, n. 1, [citado 2026-10-14], pp. 60-66. Disponível em: <https://journals.cardiol.br/article/correlation-between-surgical-risk-scales-with-respiratory-muscle-strength-and-functional-independence-in-patients-submitted-to-coronary-artery-bypass-grafting-2/>. ISSN 2359-4802

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

David TE. Pain after Cardiac Surgery. International Journal of Cardiovascular Sciences 2020;33(1):22-3.

Formato de Documento Eletrônico (ABNT)

David, Tirone E.. Pain after Cardiac Surgery. International Journal of Cardiovascular Sciences, v. 33, n. 1, p. 22-23, fev. 2020.

Formato de Documento Eletrônico (APA)

David, T. E. (2020). Pain after Cardiac Surgery. International Journal of Cardiovascular Sciences, 33(1), 22-23.

Formato de Documento Eletrônico (ISO)

David, Tirone E.. Pain after Cardiac Surgery. International Journal of Cardiovascular Sciences [online]. 2020, vol. 33, n. 1, [citado 2026-10-14], pp. 22-23. Disponível em: <https://journals.cardiol.br/article/pain-after-cardiac-surgery-2/>. ISSN 2359-4802

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

Silva JF, Cavalcante MP, Montenegro RB, Lira R, Mel EC, Castro JV. Minimally Invasive Cardiac Surgery versus Sternotomy – Pain Investigation. International Journal of Cardiovascular Sciences 2019;33(1):24-33.

Formato de Documento Eletrônico (ABNT)

Silva, Juliana Fernandes; Cavalcante, Marcela Paula; Montenegro, Roger Benevides; Lira, Romulo; Mel, Emanuel Carvalho; Castro, Josue Viana. Minimally Invasive Cardiac Surgery versus Sternotomy – Pain Investigation. International Journal of Cardiovascular Sciences, v. 33, n. 1, p. 24-33, ago. 2019.

Formato de Documento Eletrônico (APA)

Silva, J. F., Cavalcante, M. P., Montenegro, R. B., Lira, R., Mel, E. C., & Castro, J. V. (2019). Minimally Invasive Cardiac Surgery versus Sternotomy – Pain Investigation. International Journal of Cardiovascular Sciences, 33(1), 24-33.

Formato de Documento Eletrônico (ISO)

Silva, Juliana Fernandes and Cavalcante, Marcela Paula and Montenegro, Roger Benevides and Lira, Romulo and Mel, Emanuel Carvalho and Castro, Josue Viana. Minimally Invasive Cardiac Surgery versus Sternotomy – Pain Investigation. International Journal of Cardiovascular Sciences [online]. 2019, vol. 33, n. 1, [citado 2026-10-14], pp. 24-33. Disponível em: <https://journals.cardiol.br/article/minimally-invasive-cardiac-surgery-versus-sternotomy-pain-investigation-2/>. ISSN 2359-4802

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