Ana Lúcia De Mattia

Hipotermia em pacientes no período perioperatório

The objective of this study was to identify the factors that trigger hypothermia in patients in surgery, and the manifestations in the anesthesia recovery room. This study was performed in a large hospital of the City of Santos hospital network. Data were collected from 30 adult patients, whose body temperature when entering the surgical suite was between 36ºC and 37.2ºC, who underwent elective procedures and received general anesthesia. Results show that the most common methods used to prevent hypothermia were infusing warmed intravenous fluids and using a thermal blanket. From the moment the patient left the surgical suite until 30 minutes post-recovery in the anesthesia recovery room, patients remained hypothermic. Hypothermia was manifested by hypoxemia and shivering. In this study, it was shown that hypothermia in patients is triggered while in the surgical suite due to the lack of appropriate preventive measures, leading to complications in the anesthesia recovery period.O objetivo deste estudo foi identificar os fatores que desencadeiam a hipotermia em pacientes em sala de operacao e as manifestacoes em sala de recuperacao anestesica. O estudo foi realizado em um hospital de grande porte da rede mista da cidade de Santos. A coleta de dados foi realizada em 30 pacientes adultos, com temperatura corporea entre de 36oC e 37,2oC na entrada da sala de operacoes com procedimentos cirurgicos eletivos e anestesia geral. Os resultados demonstraram que os metodos preventivos de hipotermia mais utilizados foram a infusao venosa aquecida e a manta termica. Na saida da sala de operacao e ate 30 minutos na sala de recuperacao anestesica, os pacientes permaneceram hipotermicos. As manifestacoes de hipotermia foram demonstradas pela hipoxemia e por tremores. Neste estudo, evidenciou-se que a hipotermia no paciente e desencadeada na sala de operacao pela falta de medidas preventivas adequadas, acarretando complicacoes em periodo de recuperacao anestesica.

Hypothermia in patients during the perioperative period

The objective of this study was to identify the factors that trigger hypothermia in patients in surgery, and the manifestations in the anesthesia recovery room. This study was performed in a large hospital of the City of Santos hospital network. Data were collected from 30 adult patients, whose body temperature when entering the surgical suite was between 36ºC and 37.2ºC, who underwent elective procedures and received general anesthesia. Results show that the most common methods used to prevent hypothermia were infusing warmed intravenous fluids and using a thermal blanket. From the moment the patient left the surgical suite until 30 minutes post-recovery in the anesthesia recovery room, patients remained hypothermic. Hypothermia was manifested by hypoxemia and shivering. In this study, it was shown that hypothermia in patients is triggered while in the surgical suite due to the lack of appropriate preventive measures, leading to complications in the anesthesia recovery period.O objetivo deste estudo foi identificar os fatores que desencadeiam a hipotermia em pacientes em sala de operacao e as manifestacoes em sala de recuperacao anestesica. O estudo foi realizado em um hospital de grande porte da rede mista da cidade de Santos. A coleta de dados foi realizada em 30 pacientes adultos, com temperatura corporea entre de 36oC e 37,2oC na entrada da sala de operacoes com procedimentos cirurgicos eletivos e anestesia geral. Os resultados demonstraram que os metodos preventivos de hipotermia mais utilizados foram a infusao venosa aquecida e a manta termica. Na saida da sala de operacao e ate 30 minutos na sala de recuperacao anestesica, os pacientes permaneceram hipotermicos. As manifestacoes de hipotermia foram demonstradas pela hipoxemia e por tremores. Neste estudo, evidenciou-se que a hipotermia no paciente e desencadeada na sala de operacao pela falta de medidas preventivas adequadas, acarretando complicacoes em periodo de recuperacao anestesica.

Warmed intravenous infusion for controlling intraoperative hypothermia

OBJETIVO: verificar la eficacia de la intervencion de infusion venosa calentada en la prevencion de la hipotermia en pacientes en el periodo intraoperatorio. METODO: estudio experimental, comparativo, de campo, prospectivo y cuantitativo, en un hospital publico federal. La muestra abarco a 60 adultos, que tuvieron como uno de los criterios de inclusion la temperatura axilar entre 36oC y 37,1oC y acceso quirurgico abdominal, divididos en grupos control y experimental, compuestos utilizandose la tecnica de muestreo probabilistico sistematico. RESULTADOS: en los 2 grupos, 22 pacientes (73,4%) salieron del quirofano con hipotermia, o sea, temperatura inferior a 36oC (p=1,0000). La temperatura del quirofano cuando de la entrada del paciente y la temperatura del paciente cuando de la entrada en el quirofano fueron estadisticamente significativas para influir en la ocurrencia de hipotermia. CONCLUSION: la planificacion e implementacion de las intervenciones de enfermeria practicadas por el enfermero son esenciales para prevenir la hipotermia y mantener la normotermia perioperatoria.

Hipotermia en pacientes en el período perioperatorio

The objective of this study was to identify the factors that trigger hypothermia in patients in surgery, and the manifestations in the anesthesia recovery room. This study was performed in a large hospital of the City of Santos hospital network. Data were collected from 30 adult patients, whose body temperature when entering the surgical suite was between 36ºC and 37.2ºC, who underwent elective procedures and received general anesthesia. Results show that the most common methods used to prevent hypothermia were infusing warmed intravenous fluids and using a thermal blanket. From the moment the patient left the surgical suite until 30 minutes post-recovery in the anesthesia recovery room, patients remained hypothermic. Hypothermia was manifested by hypoxemia and shivering. In this study, it was shown that hypothermia in patients is triggered while in the surgical suite due to the lack of appropriate preventive measures, leading to complications in the anesthesia recovery period.O objetivo deste estudo foi identificar os fatores que desencadeiam a hipotermia em pacientes em sala de operacao e as manifestacoes em sala de recuperacao anestesica. O estudo foi realizado em um hospital de grande porte da rede mista da cidade de Santos. A coleta de dados foi realizada em 30 pacientes adultos, com temperatura corporea entre de 36oC e 37,2oC na entrada da sala de operacoes com procedimentos cirurgicos eletivos e anestesia geral. Os resultados demonstraram que os metodos preventivos de hipotermia mais utilizados foram a infusao venosa aquecida e a manta termica. Na saida da sala de operacao e ate 30 minutos na sala de recuperacao anestesica, os pacientes permaneceram hipotermicos. As manifestacoes de hipotermia foram demonstradas pela hipoxemia e por tremores. Neste estudo, evidenciou-se que a hipotermia no paciente e desencadeada na sala de operacao pela falta de medidas preventivas adequadas, acarretando complicacoes em periodo de recuperacao anestesica.

Infusão venosa aquecida no controle da hipotermia no período intraoperatório

OBJETIVO: verificar la eficacia de la intervencion de infusion venosa calentada en la prevencion de la hipotermia en pacientes en el periodo intraoperatorio. METODO: estudio experimental, comparativo, de campo, prospectivo y cuantitativo, en un hospital publico federal. La muestra abarco a 60 adultos, que tuvieron como uno de los criterios de inclusion la temperatura axilar entre 36oC y 37,1oC y acceso quirurgico abdominal, divididos en grupos control y experimental, compuestos utilizandose la tecnica de muestreo probabilistico sistematico. RESULTADOS: en los 2 grupos, 22 pacientes (73,4%) salieron del quirofano con hipotermia, o sea, temperatura inferior a 36oC (p=1,0000). La temperatura del quirofano cuando de la entrada del paciente y la temperatura del paciente cuando de la entrada en el quirofano fueron estadisticamente significativas para influir en la ocurrencia de hipotermia. CONCLUSION: la planificacion e implementacion de las intervenciones de enfermeria practicadas por el enfermero son esenciales para prevenir la hipotermia y mantener la normotermia perioperatoria.

Complicações em idosos em sala de recuperação pós-anestésica (srpa)*

Objective: To analyze complications in the elderly in the Post-Anesthetic Care Unit (PACU). Method: A prospective, exploratory study with quantitative method, performed in a large university hospital in Belo Horizonte. The sample consisted of 50 subjects aged 60 years or older who underwent elective surgery and were classified according to the American Society of Anesthesiologists (ASA) as I or II. Data were collected through a semi-structured guide. Results: Hypothermia was the most frequent complication, followed by hypoxemia, delirium and altered level of consciousness, especially in the 60–69 years old age group. Pain, nausea and vomiting showed no significant values. Conclusion: The control and monitoring of complications presented are key activities of the nursing team in preventing the worsening of the health status of elderly patients in the anesthetic recovery period (ARP). Keywords: Perioperative nursing. Recovery room. Aged. Postoperative complications

Factors associated with knowledge of the nursing staff at a teaching hospital on blood transfusion

Objetivo: verificar si existe asociacion entre el conocimiento de los profesionales del equipo de enfermeria sobre transfusion sanguinea con las variables relacionadas a aspectos profesionales. Metodo: se trata de un estudio observacional, transversal, cuantitativo, realizado en un hospital general, de ensenanza y de gran porte. La muestra fue constituida por 209 profesionales del equipo de enfermeria, obtenida por sorteo aleatorio simple. La recoleccion de datos utilizo un instrumento del tipo lista de verificacion. En el analisis univariado, se utilizo la estadistica descriptiva y las medidas de centralidad y de dispersion. En el analisis bivariado, se utilizaron el test t de Student, el analisis de variancia y la correlacion de Pearson. Para determinar los factores de prediccion, se utilizo la regresion linear multiple. El estudio fue aprobado por el Comite de Etica en Investigacion con dictamen n° 2434. Resultados: el promedio del puntaje general de conocimiento fue de 52,66%; en la Etapa de Pre-transfusion fue de 53,38%; en la Etapa de Transfusion, 51,25%; y, en la Etapa Post-transfusion, 62,68%. Los factores relacionados al conocimiento fueron: categoria profesional y recibir entrenamiento y/u orientacion para la realizacion del proceso de transfusion (p<0,01). Conclusion: este estudio evidencio la influencia del entrenamiento y la orientacion sobre el conocimiento y suministro un diagnostico para la identificacion de las dificultades de los profesionales relacionadas al proceso de transfusionObjetivo:verificar se ha associacao entre o conhecimento dos profissionais da equipe de enfermagem sobre hemotransfusao e as variaveis relacionadas aos aspectos profissionais.Metodo:trata-se de um estudo observacional, transversal, quantitativo, realizado em um hospital geral, de ensino e de grande porte. A amostra foi constituida por 209 profissionais da equipe de enfermagem, obtida por sorteio aleatorio simples. A coleta de dados utilizou um instrumento do tipo checklist. Na analise univariada, utilizaram-se estatistica descritiva e medidas de centralidade e de dispersao. Na analise bivariada, utilizaram-se o Teste t de Student, a analise de variância e a correlacao de Pearson. Para determinar os preditores, utilizou-se a regressao linear multipla. O estudo foi aprovado pelo Comite de Etica em Pesquisa (Parecer n° 2434).Resultados:a media de escore geral de conhecimento foi de 52,66%, na Etapa Pre-transfusional foi de 53,38%; na Etapa Transfusional, 51,25%; e na Etapa Pos-transfusional, 62,68%. Os fatores relacionados ao conhecimento foram categoria profissional e receber treinamento e/ou orientacao para a realizacao do processo transfusional (p<0,01).Conclusao:este estudo evidenciou a influencia do treinamento e orientacao sobre o conhecimento e forneceu um diagnostico para a identificacao das dificuldades dos profissionais relacionadas ao processo transfusional.

Body mass index as discriminator of the lean mass deficit and excess body fat in institutionalized elderly people

The objective of this study was to identify the discriminating criterion for body mass index (BMI) in the prediction of low fat free mass and high body fat percentage according to sex among older people. Observational analytical study with cross-sectional design was used for this study. All institutionalized older people from the city of Uberaba (Minas Gerais, Brazil) who fit within the inclusion and exclusion criteria were approached. Sixty-five institutionalized older people were evaluated after signing a Free and Informed Consent Form. Descriptive and inferential statistical procedures were employed for the analysis, using Students t-test and multiple linear regression. Receiver Operating Characteristic (ROC) curves were constructed to determine the BMI (kg/m(2)) cut-off points. The study complied with all the ethical norms for research involving human beings. In comparing the anthropometric measurements obtained via bioimpedance, elder male had higher mean height and body water volume than females. However, women had higher mean triceps skinfold and fat free mass than men. The BMI cut-off points, as discriminators of low fat free mass percentage and high body fat percentage in women, were ≤22.4 kg/m(2) and >26.6 kg/m(2), respectively; while for men they were ≤19.2 kg/m(2) and >23.8 kg/m(2). The results of this study indicate the need for multicenter studies aimed at suggesting BMI cut-off points for institutionalized older people, taking into account specific sex characteristics.

Condutas de enfermagem adotadas diante dos eventos adversos à doação de sangue

Esta investigacion tuvo como objetivo identificar los tipos de eventos adversos, las manifestaciones clinicas y las conductas de enfermeria adoptadas, asi como verificar una asociacion entre estas conductas y los eventos adversos. Estudio epidemiologico, retrospectivo realizado despues del analisis de 1369 historias clinicas de las reacciones adversas a la donacion, durante el periodo comprendido entre enero 2009 a diciembre 2011. Se utilizo estadistica descriptiva y tablas de contingencia para analizar la asociacion, asi como el coeficiente de Cramer. Fueron clasificados como leves 92,6% eventos adversos y las manifestaciones clinicas fueron malestar general, mareos, palidez y sudoracion. La posicion de Trendelenburg, la medicion de los signos vitales, la hidratacion oral y las directrices para el cuidado despues de la donacion fueron las principales conductas aprobadas. La significacion estadistica se observo entre la mayoria de los procedimientos de enfermeria adoptados y los tipos de eventos adversos. Los resultados evidencian el papel fundamental de la enfermeria antes de la ocurrencia de eventos adversos con la donacion de sangre.The aim of this study was to identify types of adverse events, clinical manifestations and nursing care procedures adopted in response to adverse events to blood donation, and to verify the association between these procedures and the adverse events. This was an epidemiological, retrospective study conducted through analysis of 1369 records of treatment of adverse events to blood donation, during the period between January 2009 and December 2011. Descriptive statistics and contingency tables were used to analyze associations through the use of Cramers V. A total of 92.6% of adverse events were classified as mild, and clinical manifestations were malaise, dizziness, pallor and sweating. The Trendelenburg position, vital signs monitoring, oral hydration and directions for care after blood donation were the main procedures adopted. A statistical significance was observed between the nursing procedures and the types of adverse events. The results point to the critical role of nursing in treating adverse events to blood donation. DESCRIPTORS: Blood donors. Nursing care. Blood safety.

Nursing care procedures in response to adverse events to blood donation

Esta investigacion tuvo como objetivo identificar los tipos de eventos adversos, las manifestaciones clinicas y las conductas de enfermeria adoptadas, asi como verificar una asociacion entre estas conductas y los eventos adversos. Estudio epidemiologico, retrospectivo realizado despues del analisis de 1369 historias clinicas de las reacciones adversas a la donacion, durante el periodo comprendido entre enero 2009 a diciembre 2011. Se utilizo estadistica descriptiva y tablas de contingencia para analizar la asociacion, asi como el coeficiente de Cramer. Fueron clasificados como leves 92,6% eventos adversos y las manifestaciones clinicas fueron malestar general, mareos, palidez y sudoracion. La posicion de Trendelenburg, la medicion de los signos vitales, la hidratacion oral y las directrices para el cuidado despues de la donacion fueron las principales conductas aprobadas. La significacion estadistica se observo entre la mayoria de los procedimientos de enfermeria adoptados y los tipos de eventos adversos. Los resultados evidencian el papel fundamental de la enfermeria antes de la ocurrencia de eventos adversos con la donacion de sangre.The aim of this study was to identify types of adverse events, clinical manifestations and nursing care procedures adopted in response to adverse events to blood donation, and to verify the association between these procedures and the adverse events. This was an epidemiological, retrospective study conducted through analysis of 1369 records of treatment of adverse events to blood donation, during the period between January 2009 and December 2011. Descriptive statistics and contingency tables were used to analyze associations through the use of Cramers V. A total of 92.6% of adverse events were classified as mild, and clinical manifestations were malaise, dizziness, pallor and sweating. The Trendelenburg position, vital signs monitoring, oral hydration and directions for care after blood donation were the main procedures adopted. A statistical significance was observed between the nursing procedures and the types of adverse events. The results point to the critical role of nursing in treating adverse events to blood donation. DESCRIPTORS: Blood donors. Nursing care. Blood safety.