Marcelo A Ribeiro

Estudo de segurança e eficácia da enoxaparina sódica na profilaxia e terapêutica antitrombótica

BACKGROUND AND OBJECTIVES: Use of low molecular weight heparins (LMWH), either prophylactic or therapeutic, is of most importance in several syndromes and diseases in daily clinical practice. Our objective in this clinical trial was to evaluate safety and efficacy of test sodium enoxaparin (ENOX-T) compared to the reference drug (ENOX-R). METHODS: We conducted a prospective, randomized, comparative, unicentric and open-labeled trial including patients with either prophylactic or therapeutic anti-thrombotic indications. A total of 100 patients were enrolled in two branches: prophylactic (n=50) and therapeutic (n=50) and two groups for each branch (group 1: ENOX-R and group 2: ENOX-T). We analyzed clinical and laboratory data in each segment. Anti-factor Xa was measured in three different moments: baseline (1st evaluation); 1st or 2nd day (2nd evaluation) and 5th to 7th day (3rd evaluation). Doppler-sonography of inferior limbs was performed on all patients in prophylactic group on 2nd or 3rd evaluation. RESULTS: The data showed that both branches (prophylactic and therapeutic) were homogenous in regard of sex, age, body mass index (BMI), serum creatinine and APACHE II severity score at admission. Anti-factor Xa results, in both prophylactic and therapeutic branches, showed expected efficacy to both drugs, without any clinical or statistical difference between them. Adverse events incurred in both groups in a similar way, without any clinical or statistical difference between them. In prophylactic branch, Doppler-sonography of inferior limbs added useful information on drugs efficacy. CONCLUSIONS: We conclude that test sodium enoxaparin (ENOX-T) was effective and safe in our patients cohort and equivalent to reference drug (ENOX-R).

Desafios na profilaxia do tromboembolismo venoso: abordagem do paciente crítico

BACKGROUND AND OBJECTIVES: Venous thromboembolism (VTE), with includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common complication in critically ill patients, resulting in high morbidity and mortality. CONTENTS: Most patients treated in intensive care units (ICU) face a high risk of thromboembolic complications. Despite these considerations, the prevention of VTE may not be as high a priority in ICU patients as it is in other high-risk patient groups. Low molecular weight heparin (LMWH) may be the optimal prophylaxis in most ICU patients, but there is a lack of sufficient data including the paucity of VTE consensus and guidelines documents pertaining to critically ill patients. CONCLUSIONS: This article reviews background, current options, and recommendations regarding VTE in intensive care population emphasizing special diagnostic and treatment considerations in the ICU setting.

CRT-400.01 Training, Simulation and Validation of Therapeutic Hypothermia as an Adjuvant Treatment in St Segment Elevation Myocardial Infarction

Therapeutic hypothermia (TH) reduces the damage by ischemic / reperfusion syndrome in cases of cardiac arrest, in which its application is already widely established and carried out in centers of excellence. However its use in patients with ST segment elevation myocardial infarction (STEMI) is still

CRT-700.06 Safety of Endovascular Therapeutic Hypothermia as an Adjuvant Therapy in Acute ST Segment Elevation Myocardial Infarction

Therapeutic hypothermia (TH) reduces the damage by ischemia and reperfusion cell syndrome in cardiac arrests, in which its application is already widely established and carried out in centers of excellence. However its role in patients with acute ST segment elevation myocardial infarction (STEMI)

Results from inhospital cardiopulmonary resuscitation records in a medical cardiologic ICU

New techniques have been used in cardiopulmonary resuscitation (CPR) since the introduction of closed cardiac massage in 1960. Despite this progress, there has been no significant improvement in survival rates after inhospital cardiac arrest over the past 40 years. In a general hospital, survival rates at discharge, not considering specifically ICU patients, is around 15–20%. Few data are available considering survival in cardiologic care units.