Assistência de enfermagem e o risco para úlceras de pressão medido pela Escala de Braden em unidade de terapia intensiva

The problem facing the incidence of pressure ulcers (UP) in the hospital environment especially in the intensive care unit (ICU), although it is an old and frequent event in our professional practice, it is not notified in the researches as much as it should be. We observed a tendency to invest in therapeutical and in studies about the production of sophisticated new bandages. Few, however, are the investments in research on preventive measures in order to prevent or at least slow down the development of lesions. In this sense, the study aimed to analyze the correlation between nursing care and the risk of developing UP measured by the Braden scale in ICU patients. This is a descriptive study of longitudinal quantitative approach. The project obtained a favourable opinion from the Ethics Committee of HUOL (no 486/10). Data collection was carried out in the Hospital of Unimed in Natal during six months in 2011. The sample was of 32 patients hospitalized in ICU for over four days. The results were processed in SPSS 15.0 for descriptive statistics and inferential statistics. We identified that, only 9.4% of our sample developed UP, being predominantly male, elderly people aged above 60 years, Caucasian, with diagnostic hypothesis at the time of hospitalization of sepsis, were clinical patients, who presented hemodynamic instability, using orotracheal tube (TOT), enteral probe (SNE), vesical probe delay (SVD) and had values of albumin and hemoglobin levels below normal. In addition, these patients had a longer hospital stay, longer usage of TOT, SNE, SVD, increased use of sedation and drain than those who did not develop UP and were all at risk for developing these injuries second Braden scores. 66.7% of the lesions developed were located in the sacral region, limiting the degree I and all patients that developed were considered serious, 100.0% of them have evolved since the death. Small were the differences between the averages of Braden scores between patients with and without UP, 11,9+2,4 against 12,4+2,6 with p = 0.627. The clinical aspects of the patients in the study were instrumental in the development of UP, once, these findings were statistically significant through the Mann-Whitney test, and appropriateness of nursing conduct was decisive for the prevention of pressure ulcers in critical patients, since many were those classified as at risk (28) and few who have developed lesions (03)

Segurança do paciente no sistema de medicação: análise de enfermeiros de um hospital de ensino

This study aimed to identify and describe the factors related to Patient Safety in a medication system according to the nurses analysis in a teaching hospital from the photographic analysis method. This was a cross-sectional, descriptive study with mixed approach in a teaching hospital in Rio Grande do Norte. The population consisted of 42 nurses from inpatient units, of which 34 composed the study sample. As eligibility criteria, we defined nurses from public service and nurses who agreed to participate. Ethical determinations were observed, the study was submitted to the Ethics and Research of the University Hospital Onofre Lopes, obtaining the assent with ethical assessment certificate (CAAE 0098.0.051.294-11). For data collection, we used the photographic method (Photographic Analysis Technique) by Patricia Marck (Canada). It was developed in two phases: at first, we randomly captured photos from the medication system, resulting in 282 images; then we selected/processed the photographs, which were reduced to 10 images in Microsoft Excel 2010; in the second phase, the nurses answered the questionnaire divided into socio-professional profile and Digital Photography Scoring Tool (questions a and b ). For analysis of the question a , we used the content analysis technique, and for b , we used the Statistical Package for the Social Sciences 20.0 (temporary license). The socio-professional profile revealed the predominance of females; age group 34-43 years; professionals with specialization; 10-18 years of length of service; and nurses working exclusively in the hospital and who know the Patient Safety. The photographic analysis in relation to Patient Safety resulted in specific categories for each stage of the medication system. Regarding disposal, we identified Proper verification ; Improper verification ; Correct identification ; Disposal in single doses ; and Improper Environment , with predominance of that last category. As for storage: Proper storage ; Improper storage ; Risk of exchange/disappearance ; and Poor hygiene , with special reference to improper storage. In preparation: Risk of exchanging medication/patient ; Inappropriate physical space ; and Inadequate 9 preparation of controlled drugs , highlighting the first category. In drug administration: Lack of Personal Protective Equipment ; Use of Personal Protective Equipment ; Improper administration technique ; Proper administration technique ; Correct drug identification ; Incorrect drug identification ; and Peripheral venous access without identification . From the safety assessment of 10 photographs, by adapting the scores (1-10) to the Likert Scale, we identified three Totally Unsafe (Level 1), three Unsafe (Level 2), three Partially Safe (Level 3), one Safe (Level 4), and no photograph considered Totally Safe. This study identified the prevalence of unsafety in the medication system in the nurses opinion. We were also able to understand that, although nurses identify safety aspects, the most prevalent categories characterize an unsafe assessment. Nursing needs to reflect on its practice, identifying gaps in the medication system in order to achieve a proper and safe care

Acurácia dos indicadores clínicos do diagnóstico de enfermagem volume de líquidos excessivo em pacientes submetidos à hemodiálise

Trasnversal study, with the objective of evaluating the accuracy of clinical indicators of nursing diagnosis excessive fluid volume in patients undergoing hemodialysis. The study occurred in two stages, the first consisted of the evaluation of the diagnostic indicators in study; and the second, the diagnostic inference conducted by nurse diagnosticians. The first stage occurred from december 2012 to april 2013, in a University Hospital and a Hemodialysis Clinic in Northeastern of Brazil, with a sample of 100 chronic renal failure patients on hemodialysis. The data were selected through an interview form and a physical examination, organized into spreadsheets and analyzed as to the presence or absence of the indicators of diagnosis excessive fluid volume. In the second step, the spreadsheets were sent to three nurses diagnosticians, who judged the presence or absence of diagnosis in the clientele searched. This step was conducted from july to september 2013. For analysis of the data, we used descriptive and inferential statistics. In the descriptive analysis, we used measures of central tendency and dispersion. In inferential analysis, we used the tests Chi- square, Fisher and prevalence ratios. The accuracy of the clinical indicators pertaining to the diagnosis were measured as to the specificity, sensitivity, predictive values, likelihood ratios and Diagnostic Odds Ratio. Also developed a logistic regression. The results were organized in tables and discussed with literature. This study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte, with Presentation Certificate for Ethics Appreciation nº 08696212.7.0000.5537. The results revealed that the diagnosis studied was present in 82% of patients. The characteristics with prevalence above 50 % that stood out were: azotemia, decreased hematocrit, electrolyte imbalance, intake exceeds output, anxiety, edema, decreased hemoglobin, oliguria and blood pressure changes. Eight defining characteristics were presented statistically significant association with the nursing diagnosis investigated: pulmonary congestion, intake exceeds output, electrolytes imbalance, jugular vein distension, edema, weight gain over short period of time, agitation and adventitious breath sounds. Among these, the 10 characteristics which showed higher prevalence ratios were: edema and weight gain over short period of time. The features with the highest sensitivity were edema, electrolytes imbalance and intake exceeds output and the standing out with greater specificity were: anasarca, weight gain over short period of time, change in respiratory pattern, adventitious breath sounds, pulmonary congestion, agitation and jugular vein distension. The indicators jugular vein distension, electrolytes imbalance, intake exceeds output, increased central venous pressure and edema, together, were identified in the logistic regression model as the most significant predictors. It is concluded that the identification of accurate clinical indicators allow a good prediction of the nursing diagnosis of excessive fluid volume in patients undergoing hemodialysis in order to assist the nurse in the inference process, which will contribute to the success of patient care. In addition, nurses will consider for diagnostic inference not only his clinical experience, but also scientific evidence of the occurrence of excessive fluid volume, contributing to the control of volemia in these patients

Avaliação da assistência à saúde dos portadores de úlceras venosas atendidos no programa saúde da família do município de Natal/RN

Descriptive research aimed at evaluating the assistance offered to patients with venous ulcers, on lower limbs, attended by the Family Health Program (FHP) team, from the municipality of Natal/RN. The target population was composed of 74 patients with venous ulcers (VU), attended by the FHP teams in the 31 FHUs. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (protocol n.55/05). The data collection was performed in patients homes and in the FHUs, through structured interviews and physical examinations of patients with VU and non-participant observation during the changing of wound dressings in these Units and in users homes. The data was organized into an Excel electronic table and transported into the SPSS 14.0 program, for descriptive analysis on 2x2 contingency tables and inferential (Qui-Square χ2, Spearman Correlation, Binomial Proportion Test and p-value <0.05). The prevalence of VU (0.36/1000) in the target population (over 20 years of age) was greater than in the population registered in FHP (0.25/1000). We detected a greater prevalence in the age area of over 60 years (2.22/1000), with 2.98/1000 for females and 1.3/1000 for males (p-value=0.008). The sociodemographical and health characteristics of patients with VU revealed predominance of females (74.5%), elders over 60 years of age (67.6%), with fundamental education (74.3%), family earnings of up to 2 minimum wages (68.9%), retired (90.5%), ortostatic position (23.0%), inadequate sleep (59,9%), presence of CVI (100.0%), hypertension (44.6%) and diabetes (25.7%). As for the time of existence of the VU, 64.9% had over 1 year, and 35.1% less than 1 year), with predominance of one wound (67.6%). The changing of wound dressings is performed mostly at home, in and inadequate way, especially with incorrect cleaning techniques, likewise incorrect use of products and substances, and reduced participation of the FHP team on the evaluation and application of the dressing and choosing of products and substances. The compressive therapy is not part of therapeutic conducts for treatment in the FHUs. As for the evaluation of assistance to patients with VU, 90.5% were inadequate and only 9.5% adequate. The main inadequacy factors were the absence of: diagnosis (47.3%), consultation with and angiologist (63.5%), compressive treatment (100.0%), adequate optical therapy (98.62%), adequate dressing kit (70.3%), training for the changing of dressings (67.6%), following by the FHP team (51.4%) and performed exams (55.4%). We ve concluded that patients with VU mostly present now socioeconomical level and associated chronic diseases. Considering that assistance offered by FHP is non-systematic, fragmented, with no diagnosis planning, continual evaluation and evolution, we qualify the assistance as inadequate and with low level of solution, directly interfering on the maintenance of the VUs chronic state

Úlceras de pressão: um estudo com pacientes de unidade de terapia intensiva

To characterize patients according to gender, age category, internment time, diagnostical hypothesis and location of the pressure ulcer; to identify the susceptibility conditions, intrinsical and extrinsical factors present on ICU patients and to verify on the existence of association between the susceptibility conditions and the intrinsecal and extrinsecal factors on the occurrence of PU. Methods: It is a descriptive study, of longitudinal design of the panel type, with quantitative approach, performed on two ICU s of a private hospital located in Natal/RN, with 40 patients interned at these units. The data collection was performed on all three shifts through a structured observation and physical exam of the patients' skin form seeking to identify the presence of PU. Results: The greatest occurence of PU was on individuals of the male gender (70%) when compared to the female gender (30%), that difference being statistically significant (p=0,0267), with the male gender presenting 4,3 times greater chance of developing PU than the female; the predominant age category was from 60 years of age on (85%), 60,0% presented 1 to 2 PU s after 7 (seven) days of permanence in the ICU s, the predominant diagnostical hypothesis on the patients with PU were the respiratory diseases (42,3%) and the most frequent locations of PU were the sacral region (40,0%) and heels (36,0%). 25 PU s of stage I were diagnosed on 50,0% of the followed patients, with general incidence of 50,0% on both ICUs. from the 88 variables researched, 75 were identified on the patients from the study, being the predominant conditions (anemia, hypotension, leukocytosis, other diseases hypertension blood pressure, cardiac insuffience, pneumonia - and ansiolythic), the intrinsecal factors (diminished muscular strenght and/or mass, discrete edema, totally compromised mobile coordination and total inability for movement on the bed) and the extrinsecal factors (inadequate mattress type, permanence on a single position for >2 hours, shearing/friction force, bed clothes with folds that leave marks on the body, pressure force) predominated on patients with PU. The male gender variables (p=0,0267,OR=4,3), sedation (p=0,0006,OR=4,1), psychomotive agitation (p=0,0375,OR=5,8) and leukocytosis (p=0,0285,OR=5,0) presented a significant statistical diference when analyzed independently. We verified an association of 17,3%, statistically significant (p=0,0384), between the susceptibility conditions (anemia, leukocytosis and hypotension), the intrinsecal factors (age equal or above 60 years, diminished/absent pain sensibility and smooth, fine or delicate skin) and the extrinsecal factors (inadequate mattress, pressure forces, shearing/friction force, permanence on a single position for more than 2 hours, elevation between 30 to 45 degrees and inadequate bed clothes' conditions), with a chance ratio of 4,6 times the risk of occurrence of PU on the patients that presented the referred association. Conclusion: The incidence of PU detected on the ICU-interned patients was high and we made evident the existence of association between the susceptibility conditions, the intrinsecal and extrinsecal factors on the occurrence of PU s on the ICUinterned patients, and thus we accept the alternative hypothesis proposed on the study

Leptinemia de jejum em crianças e adolescentes eutróficos

OBJETIVO: Determinar, em um grupo de crianças e adolescentes eutróficos, os valores de leptinemia de jejum e sua correlação com idade e Índice de Massa Corporal (IMC). MÉTODOS: Estudo de corte transversal realizado em duas escolas públicas de Ribeirão Preto, Brasil. Foram obtidos medidas antropométricas e amostra de sangue venoso em jejum para dosagem da leptinemia de 448 crianças e adolescentes eutróficos, maturadores médios, de ambos os sexos, com idades entre 7 e 17,9 anos. Utilizando-se o teste de Mann-Whitney foram realizadas comparações entre as concentrações obtidas para meninos e meninas em cada faixa etária. Posteriormente, utilizandose o teste de Kruskal-Wallis, foram comparados os valores em cada faixa etária e, por meio do teste de correlação de Spearman, foi avaliada a correlação entre a leptinemia de jejum e a idade e entre leptinemia de jejum e o escore z do IMC. RESULTADOS: O valores de leptinemia de jejum diferiram entre meninos e meninas em todas as faixas etárias sendo sempre mais elevados para as meninas. Entre os meninos, os valores de leptinemia não apresentam variação estatisticamente significativa; entre as meninas, observou-se variabilidade, com aumento progressivo de acordo com a faixa etária. O estudo de correlação, mostrou que a leptinemia apresenta correlação positiva com o escore z do índice de massa corporal em ambos os sexos. em relação à idade, observou-se correlação apenas entre as meninas. CONCLUSÃO: Os dados apontam para a necessidade do estabelecimento de curvas de referência para a leptinemia de jejum que levem em conta o sexo, a idade e o IMC.

Atividade antiinflamatória, antiúlcera gástrica e toxicidade subcrônica do extrato etanólico de própolis

Avaliou-se a atividade antiinflamatória do extrato etanólico de própolis - EEP, . sobre o edema desencadeado por carragenina, dextrana e histamina. O EEP apresentou dose eficaz (DE50) de 650 mg/kg (v.o), inibindo significativamente o processo inflamatório desencadeado pela carragenina, mas não inibiu o produzido por dextrana. O EEP antagonizou ainda o efeito edematogênico produzido por histamina. Nas úlceras produzidas por estresse, o EPP inibiu de forma significativa a geração dos diversos tipos classificados. em todos os parâmetros analisados no estudo da toxicidade em fase de tratamento subcrônico , (hematológicos, bioquímicos e histopatológicos), o grupo tratado com o EEP não apresentou diferença significativa em relação ao grupo controle. Desta forma, sugere-se que na dose de 650 mg/kg (dose eficaz) não existe a presença de efeitos tóxicos que possam comprometer a utilização deste extrato.

In vivo CYP2E1 phenotyping as a new potential biomarker of occupational and experimental exposure to benzene

Assessing CYP2E1 phenotype in vivo may be important to predict individual susceptibility to those chemicals, including benzene, which are metabolically activated by this isoenzyme. Chlorzoxazone (CHZ), a specific CYP2E1 substrate, is readily hydroxylated to 6-OH-chlorzoxazone (6-OH-CHZ) by liver CYP2E1 and the metabolic ratio 6-OH-CHZ/CHZ in serum (MR) is a specific and sensitive biomarker of CYP2E1 activity in vivo in humans. We used this MR as a potential biomarker of effect in benzene-treated rats and, also, in humans occupationally exposed to low levels of benzene. Male Sprague-Dawley rats (375-400 g b.w.) were treated i.p. for 3 days with either a 0.5 ml solution of benzene (5 mmol/kg b.w.) in corn oil, or 0.5 ml corn oil alone. Twenty-four hours after the last injection, a polyethylene glycol (PEG) solution of CHZ (20 mg/kg b.w.) was injected i.p. in both treated and control animals. After 2, 5.10,15, 20,30,45, 60, 90, 120, 180, and 240 min from injection, 0.2 ml blood was taken from the tip tail and stored at -20 degrees C until analysis. A modified reverse phase HPLC method using a 5 mu m Ultrasphere C18 column equipped with a direct-connection ODS guard column, was used to measure CHZ and its metabolite 6-OH-CHZ in serum. No statistically significant difference in the MR was observed, at any sampling time, between benzene-treated and control rats. The concentration-versus-time area under the curve (AUC), however, was lower (p < 0.05, Mann-Whitney test), whereas the systemic clearance was higher (p < 0.05) in treated than in control rats. Eleven petrochemical workers occupationally exposed to low levels of airborne benzene (mean +/- SD, 25.0 +/- 24.4 mu g/m(3)) and 13 non-exposed controls from the same factory (mean +/- SD, 6.7 +/- 4.0 mu g/m(3)) signed an informed consent form and were administered 500 mg CHZ p.o. Two hours later a venous blood sample was taken for CHZ and 6-OH-CHZ measurements. Despite exposed subjects showed significantly higher levels of t,t-MA and S-PMA, two biomarkers of exposure to benzene, than non-exposed workers, no difference in the MR mean values +/- SD was found between exposed (0.59 +/- 0.29) and non-exposed (0.57 +/- 0.23) subjects. So, benzene was found to modify CHZ disposition, but not CYP2E1 phenotype in benzene-treated rats, nor in workers exposed to benzene, probably due to the levels of exposure being too low. (C) 2009 Elsevier B.V. All rights reserved.

Efeitos do ultrassom terapêutico sobre parâmetros morfométricos e clínicos e método de extração de metaloproteinases em sujeitos com úlceras venosas

Venous wounds cause physical, psychological and financial problems that impact the quality of life of patients. Treatment alternatives are investigated in order to reduce healthcare costs and improve quality of life of people affected by this problem. Physical resources, such as therapeutic ultrasound (US), are being considered in the treatment of ulcers as a potential healing agent. This study aimed to investigate the application of US as a treatment for venous ulcers. Subjects were divided into two groups: US group, where treatment consisted of 5 sessions of pulsed US (3 MHz, 1W/cm²) associated with compression and kinesiotherapy; and sham group, where individuals went through the same procedures, but with sham US therapy. Subjects were evaluated for wound size by planimetry and digital photography, visual analogue scale for pain, quality of life by the questionnaires SF- 36 and VEINES-QoL/Sym and enzymatic activity of metalloproteinases 2 and 9 by zymography. It was observed mean reduction in wound area of 41.58±53.8% for the US group and 63.47±37.2% for the placebo group, maintenance of quality of life scores in the US group and significant improvement (p<0.05) in the placebo group by VEINES questionnaire. It was observed decreased perception of pain in the placebo group. Sample feasibility for analysis of the protein activity of metalloproteinases 2 and 9 by zymography collected by swab method was also confirmed. Our data did not give us evidence to support the theory that the US accelerates healing of venous ulcers in a short-term analysis. However, we observed that standard care associated with compression therapy and kinesiotherapy were able to significantly shorten the progression of chronic venous ulcers

Evaluation of the genotoxic and antigenotoxic potential of Brassica oleracea L. var. acephala D.C. in different cells of mice

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Antiulcerogenic Activity of the Essential Oil of Baccharis dracunculifolia on Different Experimental Models in Rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Evaluation of antiulcer activity of the main phenolic acids found in Brazilian Green Propolis

Aim of the study: In a previous study, our group described the gastric protective effect of the hydroalcoholic extract of Brazilian green propolis. The main compounds found in Brazilian green propolis include phenolic acids, such as: caffeic, ferulic, p-coumaric and cinnamic acids. This study was therefore carried out to evaluate the antiulcerogenic property of the main phenolic acids found in Brazilian Green Propolis.Material and methods: The anti-ulcer assays were performed using the following protocols: nonsteroidal-antinflammatory drug (NSAID)-induced ulcer, ethanol-induced ulcer, and stress-induced ulcer. The effects of the phenolic acids on gastric content volume, pH and total acidity, using the pylorus ligated model, were also evaluated.Results: It was observed that treatment using doses of 50 and 250 mg/kg of caffeic, ferulic, p-coumaric and cinnamic acids and positive controls (omeprazol or cimetidine) significantly diminished the lesion index, the total area of the lesion and the percentage of lesion in comparison with the negative control groups. In addition, the percentage of ulcer inhibition was significantly higher in the groups treated with the different phenolic acids, cimetidine or omeprazol, in all the protocols used, compared with the negative control groups. In the model to determine gastric secretion, using ligated pylorus, treatment with phenolic acids and cimetidine reduced the volume of gastricjuice and total acidity and significantly increased the gastric pH (p < 0.05), compared with the control group, with the exception of the group treated with 50 mg/kg of p-coumaric acid, in which no significant difference was observed, compared with the control. In relation to the acute toxicity, none sign of toxicity was observed when phenolic acids, used in this study, were administered for rats in dose of 2000 mg/kg.Conclusions: In conclusion, the results of this study show that caffeic, ferulic, p-coumaric and cinnamic acids display antiulcer activity. (c) 2008 Elsevier B.V. All rights reserved.

The early systemic and gastrointestinal oxygenation effects of hemorrhagic shock resuscitation with hypertonic saline and hypertonic saline 6% dextran-70: A comparative study in dogs

The smaller volemic state from hypertonic (7.5%) saline (HS) solution administration in hemorrhagic shock can determine lesser systemic oxygen delivery and tissue oxygenation than conventional plasma expanders. In a model of hemorrhagic shock in dogs, we studied the systemic and gastrointestinal oxygenation effects of HS and hyperoncotic (6%) dextran-70 in combination with HS (HSD) solutions in comparison with lactated Ringer's (LR) and (6%) hydroxyethyl starch (HES) solutions. Forty-eight mongrel dogs were anesthetized, mechanically ventilated, and subjected to splenectomy. A gastric air tonometer was placed. in the stomach for intramucosal gastric CO2 (Pgco(2)) determination and for the calculation of intramucosal. pH (pHi):[pHi = pHa - log(Pgco(2)/Paco(2))].The dogs were hemorrhaged (42% of blood volume) to hold mean arterial blood pressure at 40-50 mm Hg over 30 min and were then resuscitated with LR (n = 12) in a 3:1 relation to removed blood volume; HS (n = 12), 6 mL / kg; HSD (n = 12), 6 mL / kg; and HES (mean molecular weight, 200 kDa; degree of substitution, 0.5) (n = 12) in a 1:1 relation to the removed blood volume. Hemodynamic, systemic, and gastric oxygenation variables were measured at baseline, after 30 min of hemorrhage, and 5, 60, and 120 min after intravascular fluid resuscitation. After fluid resuscitation, HS showed significantly lower arterial pH and mixed venous Po-2 and higher systemic oxygen uptake index and systemic oxygenation extraction than LR and HES (P < 0.05), whereas HSD showed significantly lower arterial pH than LR and HES (P < 0.05). Only HS and HSD did not return arterial pH and pHi to control levels (P < 0.05). In conclusion, all solutions improved systemic and gastrointestinal oxygenation after hemorrhagic shock in dogs. However, the HS solution showed the worst response in comparison to LR and HES solutions in relation to systemic oxygenation, whereas HSD showed intermediate values. HS and HSD solutions did not return regional oxygenation to control values.

Efeitos da efedrina sobre as funções cardiovascular e renal de cães sob anestesia com pentobarbital sódico

JUSTIFICATIVA E OBJETIVOS: Com a perspectiva criada por algumas pesquisas de ações diferenciadas da efedrina sobre a função renal, dependendo da dose utilizada, e considerando-se as controvérsias ainda existentes a respeito dos seus efeitos sobre a função renal, esta pesquisa experimental tem como objetivo verificar se doses diferentes de efedrina determinam efeitos hemodinâmicos e renais diferenciados. MÉTODO: em 32 cães anestesiados com pentobarbital sódico (PS), submetidos a preparação cirúrgica, cateterismo, monitorização, expansão do volume do fluido extracelular e respiração controlada, foi estudada a hemodinâmica cardiovascular e renal e a função renal. Os cães foram distribuídos aleatoriamente em quatro grupos: G controle (n = 8), com os cães permanecendo apenas sob o efeito do PS, G ef. 2 µg (n = 8), G ef. 10 µg (n = 8) e G ef. 100 µg (n = 8), com os cães recebendo efedrina nas doses respectivas de 2, 10 e 100 µg.kg-1.min-1. Os atributos cardiovasculares e renais foram estudados em 5 momentos: controle (M1 e M2), durante a infusão de efedrina (M3 e M4) e após a suspensão da infusão de efedrina (M5). RESULTADOS: Não houve diferença significante entre os grupos em relação aos atributos estudados. em G ef. 2 µg houve aumento significante de freqüência cardíaca, fluxo sangüíneo aórtico, débito urinário e excreção fracionária de sódio. em G ef. 10 µg houve aumento apenas da freqüência cardíaca e fração de filtração, enquanto em G ef. 100 µg ocorreu aumento de freqüência cardíaca, pressão arterial média, pressão venosa central, fluxo sangüíneo aórtico e hematócrito; por outro lado, ocorreu diminuição dos fluxos plasmático e sangüíneo renais e aumento da resistência vascular renal. CONCLUSÕES: A efedrina, dependendo da dose utilizada, apresenta ações hemodinâmicas e renais diferenciadas.

DNA damage in patients who underwent minimally invasive surgery under inhalation or intravenous anesthesia

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)