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ABSTRACT Objective: This study aims to investigate the ability of the six-minute walk distance (6MWD) as a prognostic marker for midterm clinical outcomes three months after coronary artery bypass grafting (CABG), to identify possible predictors of fall in 6MWD in the early postoperative period, and to establish the percentage fall in early postoperative 6MWD, considering the preoperative baseline as 100%. Methods: A prospective cohort of patients undergoing elective CABG were included. The percentage fall in 6MWD was assessed by the difference between preoperative and postoperative day (POD) five. Clinical outcomes were evaluated three months after hospital discharge. Results: There was a significant decrease in 6MWD on POD5 compared with preoperative baseline values (percentage fall of 32.5±16.5%, P<0.0001). Linear regression analysis showed an independent association of the percentage fall of 6MWD with cardiopulmonary bypass (CPB) and preoperative inspiratory muscle strength. Receiver operating characteristic curve analysis revealed that the best cutoff value of percentage fall in 6MWD to predict poorer clinical outcomes at three months was 34.6% (area under the curve = 0.82, sensitivity = 78.95%, specificity = 76.19%, P=0.0001). Conclusion: This study indicates that a cutoff value of 34.6% in percentage fall of 6MWD on POD5 was able to predict poorer clinical outcomes at three months of follow-up after CABG. Use of CPB and preoperative inspiratory muscle strength were independent predictors of percentage fall of 6MWD in the postoperative period. These findings further support the clinical application of 6MWD and propose an inpatient preventive strategy to guide clinical management over time.

https://doi.org/10.21470/1678-9741-2022-0459

Early Six-Minute Walk Test May Predict Midterm Outcomes Following Coronary Artery Bypass Grafting
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Pauletti, Hayanne O.

; Gomes, Walter José

; Rocco, Isadora S.

; Viceconte, Marcela

; Garcia, Bruna Caroline Matos

; Marcondi, Natasha O.

; Bublitz, Caroline B.

; Costa, Ariele dos Santos

; Paiva, Thâmara Pequeno de

; Spina, Giovanna Domingues

; Begot, Isis

; Silva, Célia Camelo

; Moreira, Rita Simone L.

; Branco, João Nelson Rodrigues

; Vargas, Guilherme Flora

; Hossne Jr., Nelson A.

; Arena, Ross

; Guizilini, Solange

Brazilian Journal of Cardiovascular Surgery

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2023, Volume 38 N. 4 elocation e20220459

Abstract: En | Text: En | PDF: En

https://doi.org/10.21470/1678-9741-2022-0459

Influence of compression therapy following varicose vein surgery: a prospective randomized study
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Coelho Neto, Felipe

; Araújo, Walter Junior Boim

; Belczak, Sergio

; Rui, Eduarda Ferreira

; Borsato, Beatriz Begnini

; Baldesserra, Nathália Favaretto

; Oliveira, Rodrigo Gomes de

Jornal Vascular Brasileiro

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2023, Volume 22 elocation e20220052

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Background The use of compression dressings after phlebectomy is based solely on clinical experience due to the lack of a unified set of definitive recommendations, which makes clinical practice extremely heterogeneous. Objectives To evaluate compression therapy with elastic stockings for 7 days after phlebectomy. Methods We randomly allocated 104 lower limbs with disease classified as C1 and C2 to 1 of 2 groups: an intervention group (64 limbs) – wearing elastic compression stockings for the first 7 days after phlebectomy; or a control group (40 limbs) – given conventional bandaging for 24 hours postoperatively. We compared clinical response by analyzing the evolution of symptoms, hematoma formation, and preoperative vs. postoperative limb volume. Results Pain (median 1.0 vs. 1.5, p=0.0320) and limb volume (mean 43.7 vs. 99.8, p=0.0071) were significantly improved in patients wearing elastic compression stockings for 7 days after phlebectomy compared with controls. Conclusions Use of elastic compression therapy for 7 days after phlebectomy was effective for improving pain and lower limb volume.

Resumo Contexto O uso de curativos após flebectomia é baseado apenas na experiência clínica, visto que não existe um conjunto unificado de recomendações definitivas, o que torna a prática clínica extremamente variável. Objetivos Avaliar o uso de terapia elástica compressiva por 7 dias após flebectomia. Métodos Cento e quatro membros inferiores, classificados como CEAP C1 e C2, foram randomizados em dois grupos: grupo de intervenção (64 membros) – uso de meia elástica por 24 horas após a cirurgia – e grupo controle (40 membros) – uso de curativo convencional por 7 dias após a cirurgia. A resposta clínica foi comparada por meio de análise da evolução dos sintomas, de hematoma e do volume dos membros antes e depois da cirurgia. Resultados Os pacientes submetidos a terapia compressiva elástica apresentaram melhora significativa na dor (mediana 1,0 vs. 1,5; p=0,0320) e no volume dos membros (média 43,7 vs. 99,8; p=0,0071) em comparação ao grupo controle. Conclusões O emprego da terapia compressiva elástica por 7 dias após flebectomia mostrou-se efetivo na melhora da dor e do volume dos membros inferiores.

https://doi.org/10.1590/1677-5449.202200522

The South American Society of Cardiology (SSC) and the Latin American Association of Cardiac and Endovascular Surgery (LACES) Statement on the 2021 ACC/AHA/SCAI Guidelines for Coronary Artery Revascularization
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Soca, Gerardo

; Martínez, Alejandro

; Gomes, Walter J.

; Solano, Jose Guillermo

; Almeida, Rui

; Ibañez, Maria Alejandra

; Marin-Cuartas, Mateo

; Hurtado, Graciela

; Dayan, Victor

Brazilian Journal of Cardiovascular Surgery

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2023, Volume 38 N. 5 elocation e20230119

Abstract: En | Text: En | PDF: En

https://doi.org/10.21470/1678-9741-2023-0119

Artificial Intelligence is Irreversibly Bound to Academic Publishing — ChatGPT is Cleared for Scientific Writing and Peer Review
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Gomes, Walter J.

; Evora, Paulo R. B.

; Guizilini, Solange

Brazilian Journal of Cardiovascular Surgery

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2023, Volume 38 N. 4 elocation e20230963

Abstract: En | Text: En | PDF: En

https://doi.org/10.21470/1678-9741-2023-0963

Brazilian guidelines on chronic venous disease of the Brazilian Society of Angiology and Vascular Surgery
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Kikuchi, Rodrigo

; Nhuch, Claudio

; Drummond, Daniel Autran Burlier

; Santiago, Fabricio Rodrigues

; Coelho Neto, Felipe

; Mauro, Fernanda de Oliveira

; Silveira, Fernando Trés

; Peçanha, Guilherme Peralta

; Merlo, Ivanesio

; Corassa, Jose Marcelo

; Stambowsky, Leonardo

; Figueiredo, Marcondes

; Takayanagi, Miriam

; Gomes Flumignan, Ronald Luiz

; Evangelista, Solange Seguro Meyge

; Campos Jr., Walter

; Joviliano, Edwaldo Edner

; Araujo, Walter Junior Boim de

; Oliveira, Julio Cesar Peclat de

Jornal Vascular Brasileiro

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2023, Volume 22 elocation e20230064

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract The Brazilian Society of Angiology and Vascular Surgery has set up a committee to provide new evidence-based recommendations for patient care associated with chronic venous insufficiency. Topics were divided in five groups: 1. Classification, 2. Diagnosis, 3. Conservative or non-invasive treatment, 4. Invasive treatment and 5. Treatment of small vessels. This last series is closely related to the activities of Brazilian angiologists and vascular surgeons, who are heavily involved in the treatment of small superficial veins. These guidelines are intended to assist in clinical decision-making for attending physicians and health managers. The decision to follow a guideline recommendation should be made by the responsible physician on a case-by-case basis taking into account the patient's specific condition, as well as local resources, regulations, laws, and clinical practice recommendations.

Resumo A Sociedade Brasileira de Angiologia e de Cirurgia Vascular organizou uma comissão para fornecer novas recomendações baseadas em evidências sobre questões críticas de atendimento ao paciente com insuficiência venosa crônica. São abordados aqui os temas de classificação, diagnóstico, tratamento conservador, tratamento invasivo e tratamento de pequenos vasos. Esta última série está muito relacionada à atividade de angiologistas e cirurgiões vasculares, que possuem forte atuação no tratamento de pequenas veias superficiais. Estas diretrizes destinam-se a auxiliar na tomada de decisões clínicas de médicos assistentes e gestores de saúde. A decisão de seguir uma recomendação de diretriz deve ser feita pelo médico responsável caso a caso, levando em consideração a condição específica do paciente, bem como recursos locais, regulamentos, leis e recomendações de prática clínica.

https://doi.org/10.1590/1677-5449.202300642

Diretrizes brasileiras de diagnóstico e tratamento de lesões vasculares traumáticas
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Góes Junior, Adenauer Marinho de Oliveira

; Parreira, José Gustavo

; Kleinsorge, Gustavo Henrique Dumont

; Dalio, Marcelo Bellini

; Alves, Pedro Henrique Ferreira

; Gomes, Francisco João Sahagoff de Deus Vieira

; Araujo, Walter Junior Boim de

; Joviliano, Edwaldo Edner

; Oliveira, Julio Cesar Peclat de

Jornal Vascular Brasileiro

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2023, Volume 22 elocation e20230042

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Trauma is a leading cause of death, permanent disability, and health care cost worldwide. The young and economically active are the most affected population. Exsanguination due to noncompressible torso hemorrhage is one of the most frequent causes of early death, posing a significant challenge to trauma and vascular surgeons. The possibility of limb loss due to vascular injuries must also be considered. In recent decades, the approach to vascular injuries has been significantly modified. Angiotomography has become the standard method for diagnosis, endovascular techniques are currently incorporated in treatment, and damage control, such as temporary shunts, is now the preferred approach for the patients sustaining physiological derangement. Despite the importance of this topic, few papers in the Brazilian literature have offered guidelines on vascular trauma. The Brazilian Society of Angiology and Vascular Surgery has developed Projetos Diretrizes (Guideline Projects), which includes this publication on vascular trauma. Since treating trauma patients is a multidisciplinary effort, the Brazilian Trauma Society (SBAIT) was invited to participate in this project. Members of both societies reviewed the literature on vascular trauma management and together wrote these guidelines on vascular injuries of neck, thorax, abdomen, and extremities.

Resumo Trauma é uma causa importante de morbimortalidade, que acomete principalmente jovens. A hemorragia incoercível é o principal mecanismo de óbito precoce nessas vítimas, e as lesões vasculares não compressíveis representam grandes desafios para os cirurgiões. O traumatismo vascular impacta diretamente a viabilidade de membros traumatizados, aumentando o risco de amputação. Nas últimas décadas, muitas condutas de diagnóstico e tratamento de lesões vasculares traumáticas foram modificadas. A angiotomografia suplantou a angiografia como padrão ouro para diagnóstico, as técnicas endovasculares foram incorporadas ao arsenal terapêutico e o conceito de “controle de danos” foi estabelecido. No entanto, há lacunas na literatura nacional sobre a normatização de condutas em trauma vascular, principalmente considerando as limitações do Brasil. Por isso, a Sociedade Brasileira de Angiologia e de Cirurgia Vascular e a Sociedade Brasileira de Atendimento Integrado ao Traumatizado revisaram a literatura disponível sobre trauma vascular e organizaram diretrizes sobre o diagnóstico e tratamento dessas lesões.

https://doi.org/10.1590/1677-5449.202300421

Desvendando as Controvérsias da Dissecção Aórtica Tipo B – Interpretando as Evidências
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Gomes, Walter J.

; Gomes, Eduardo N.

; Hossne Jr., Nelson A.

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 8 elocation e20230550

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

https://doi.org/10.36660/abc.20230550

Enxerto Multiarterial na Cirurgia de Revascularização Coronária. A Busca Renovada por Resultados Aprimorados Coronária
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Gomes, Walter J.

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 3 elocation e20230094

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20230094

10.

Guidelines on vascular access for hemodialysis from the Brazilian Society of Angiology and Vascular Surgery
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Harduin, Leonardo de Oliveira

; Barroso, Thiago Almeida

; Guerra, Julia Bandeira

; Filippo, Marcio Gomes

; Almeida, Leonardo Cortizo de

; Castro-Santos, Guilherme de

; Oliveira, Fabio Augusto Cypreste

; Cavalcanti, Douglas Eduardo Tavares

; Procopio, Ricardo Jayme

; Lima, Eduardo Cavalcanti

; Pinhati, Matheus Eduardo Soares

; Reis, Jose Maciel Caldas dos

; Moreira, Barbara D’Agnoluzzo

; Galhardo, Adriano Martins

; Joviliano, Edwaldo Edner

; Araujo, Walter Junior Boim de

; Oliveira, Julio Cesar Peclat de

Jornal Vascular Brasileiro

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2023, Volume 22 elocation e20230052

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo A doença renal crônica é um problema de saúde pública global e em seu estágio terminal está associada à necessidade de terapia dialítica. A grande maioria dos pacientes que necessitam realizar a terapia renal substitutiva, a fazem através da hemodiálise. Portanto, o acesso vascular é de extrema importância para a população dialítica, implicando diretamente na qualidade de vida e na morbimortalidade deste grupo de pacientes. Sendo a confecção, gerenciamento e resgate dos acessos vasculares uma das áreas de atuação do cirurgião vascular, é de grande importância a elaboração de uma diretriz que oriente o especialista no manejo mais adequado do acesso vascular para hemodiálise. Assim, o objetivo desta diretriz é apresentar um conjunto de recomendações para guiar as decisões na referenciação, avaliação, escolha, vigilância e gestão das complicações do acesso vascular para hemodiálise. dialítica substitutiva hemodiálise Portanto confecção Assim referenciação avaliação escolha

Abstract Chronic kidney disease is a worldwide public health problem, and end-stage renal disease requires dialysis. Most patients requiring renal replacement therapy have to undergo hemodialysis. Therefore, vascular access is extremely important for the dialysis population, directly affecting the quality of life and the morbidity and mortality of this patient population. Since making, managing and salvaging of vascular accesses falls within the purview of the vascular surgeon, developing guideline to help specialists better manage vascular accesses for hemodialysis if of great importance. Thus, the objective of this guideline is to present a set of recommendations to guide decisions involved in the referral, evaluation, choice, surveillance and management of complications of vascular accesses for hemodialysis. problem endstage end stage Therefore population making surgeon importance Thus referral evaluation choice

https://doi.org/10.1590/1677-5449.202300522

11.

Case Series of Right Colon Diverticulitis in the West: A Neglected Disease?
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Sobrado, Lucas Faraco

; Caldas, Tarsila Gomes

; Facanali, Carolina Graciolli

; Bustamente-Lopez, Leonardo

; Sobrado, Carlos Walter

Journal of Coloproctology (Rio de Janeiro)

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dec 2022, Volume 42 N. 4 Pages 302 - 307

Abstract: En | Text: En | PDF: En

Abstract Introduction Right colon diverticulitis (RCD) is an uncommon condition in Western populations, but its incidence has increased over the last decades. Due to its rarity, many surgeons are unfamiliar with this disease, which is often mistakenly diagnosed as acute appendicitis. The lack of data about the diagnosis and management of RCD in Western populations makes it difficult to establish the optimal therapeutic strategy. Objective To evaluate the outcomes of patients treated for acute RCD and to propose a therapeutic algorithm for the diagnosis and treatment. Methods A retrospective analysis of the medical records of patients treated for acute RCD between 2008 and 2020 by a single experienced colorectal surgeon was performed. Results In total, 12 patients were identified, 8 male and 4 female subjects, with a mean age of 49.6 years; 9 of these patients were of Western origin. The median follow-up time was of 49 months (range: 12 to 144 months). The most frequent symptoms were abdominal pain (100%) and fever (66%). Diagnostic errors in imaging exams occurred in four patients. A total of 6 patients were managed clinically, and the other 6 underwent surgical treatment with right colectomy (n = 5) and total colectomy (n = 1), 2 via laparoscopy and 4 through a laparotomy. The anatomopathological examination confirmed RCD in all operated patients. There was no incidental finding of neoplasia and there were no deaths during the study period. Conclusion Uncomplicated RCD can be treated conservatively with a high success rate. Recurrent cases that impact quality of life or complicated forms of RCD should undergo surgical treatment, preferably through a right laparoscopic colectomy. The authors present a diagnostic and therapeutic algorithm to facilitate the diagnosis and to guide the management of this uncommon disease.

https://doi.org/10.1055/s-0042-1757953

12.

The No-touch Saphenous Vein Graft in Coronary Artery Bypass Surgery. Towards a New Standard?
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Gomes, Walter J.

; Kim, Ki-Bong

; Pinheiro, Bruno Botelho

; Souza, Domingos S. R.

Brazilian Journal of Cardiovascular Surgery

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2022, Volume 37 N. spe1 Pages I - II

Abstract: En | Text: En | PDF: En

https://doi.org/10.21470/1678-9741-2022-0955

13.

COVID-19 in the Perioperative Period of Cardiovascular Surgery: the Brazilian Experience
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Gomes, Walter J.

; Rocco, Isadora

; Pimentel, Wallace S.

; Pinheiro, Aislan H. B.

; Souza, Paulo M. S.

; Costa, Luiz A. A.

; Teixeira, Marjory M. P.

; Ohashi, Leonardo P.

; Bublitz, Caroline

; Begot, Isis

; Moreira, Rita Simone L

; Hossne Jr, Nelson A.

; Vargas, Guilherme F.

; Branco, João Nelson R.

; Teles, Carlos A.

; Medeiros, Eduardo A. S.

; Sáfadi, Camila

; Rampinelli, Amândio

; Moratelli Neto, Leopoldo

; Rosado, Anderson Rosa

; Mesacasa, Franciele Kuhn

; Capriata, Ismael Escobar

; Segalote, Rodrigo Coelho

; Palmieri, Deborah Louize da Rocha Vianna

; Jardim, Amanda Cristina Mendes

; Vianna, Diego Sarty

; Coutinho, Joaquim Henrique de Souza Aguiar

; Jazbik, João Carlos

; Coutinho, Henrique Madureira da Rocha

; Kikuta, Gustavo

; Almeida, Zely Sant'Anna Marotti de

; Feguri, Gibran Roder

; Lima, Paulo Ruiz Lucio de

; Franco, Anna Carolina

; Borges, Danilo de Cerqueira

; Cruz, Felipe Ramos Honorato De La

; Croti, Ulisses Alexandre

; Borim, Bruna Cury

; Marchi, Carlos Henrique De

; Goraieb, Lilian

; Postigo, Karolyne Barroca Sanches

; Jucá, Fabiano Gonçalves

; Oliveira, Fátima Rosane de Almeida

; Souza, Rafael Bezerra de

; Zilli, Alexandre Cabral

; Mas, Raul Gaston Sanchez

; Bettiati Junior, Luiz Carlos

; Tranchesi, Ricardo

; Bertini Jr, Ayrton

; Franco, Leandro Vieira

; Fernandes, Priscila

; Oliveira, Fabiana

; Moraes Jr, Roberto

; Araújo, Thiago Cavalcanti Vila Nova de

; Braga, Otávio Penna

; Pedrosa Sobrinho, Antônio Cavalcanti

; Teixeira, Roberta Tavares Barreto

; Camboim, Irla Lavor Lucena

; Gomes, Eduardo Nascimento

; Reis, Pedro Horigushi

; Garcia, Luara Piovan

; Scorsioni, Nelson Henrique Goes

; Lago, Roberto

; Guizilini, Solange

Brazilian Journal of Cardiovascular Surgery

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dec 2021, Volume 36 N. 6 Pages 725 - 735

Abstract: En | Text: En | PDF: En

Abstract Introduction: We investigated the clinical course and outcomes of patients submitted to cardiovascular surgery in Brazil and who had developed symptoms/signs of coronavirus disease 2019 (COVID-19) in the perioperative period. Methods: A retrospective multicenter study including 104 patients who were allocated in three groups according to time of positive real time reverse transcriptase-polymerase chain reaction (RT-PCR) for the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2): group 1, patients who underwent cardiac surgery > 10 days after positive RT-PCR; group 2, patients with a positive RT-PCR within 10 days before or after surgery; group 3, patients who presented positive RT-PCR > 10 days after surgery. The primary outcome was mortality and secondary outcomes were postoperative complications, intensive care unit (ICU) length of stay, and postoperative days of hospitalization. Results: The three groups were similar with respect to age, the European System of Cardiac Operative Risk Evaluation score, and comorbidities, except hypertension. Postoperative complications and death were significantly higher in groups 2 and 3 than in group 1, and no significant difference between groups 2 and 3 was seen. Group 2 showed a high prevalence of surgery performed as an urgent procedure. Although no significant differences were observed in ICU length of stay, total postoperative hospitalization time was significantly higher in group 3 than in groups 1 and 2. Conclusion: COVID-19 affecting the postoperative period of patients who underwent cardiovascular surgery is associated with a higher rate of morbidity and mortality. Delaying procedures in RT-PCR-positive patients may help reduce risks of perioperative complications and death.

https://doi.org/10.21470/1678-9741-2021-0960

14.

The Anaortic Technique with Bilateral Internal Thoracic Artery Grafting - Filling the Gap in Coronary Artery Bypass Surgery
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Gomes, Walter J.

; Gomes, Eduardo N.

; Bertini Jr, Ayrton

; Reis, Pedro H.

; Hossne Jr, Nelson A.

Brazilian Journal of Cardiovascular Surgery

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jun 2021, Volume 36 N. 3 Pages 397 - 405

Abstract: En | Text: En | PDF: En

Abstract Coronary artery bypass grafting (CABG) has consolidated its role as the most effective procedure for treating patients with advanced atherosclerotic coronary artery disease, reducing the long-term risk of myocardial infarction and death compared to other therapies and relieving angina. Despite the recognized benefits afforded by surgical myocardial revascularization, a subset of higher-risk patients bears a more elevated risk of perioperative stroke. Stroke remains the drawback of conventional CABG and has been strongly linked to aortic manipulation (cannulation, cross‐clamping, and side-biting clamping for the performance of proximal aortic anastomoses) and the use of cardiopulmonary bypass. Adoption of off-pump CABG (OPCAB) is demonstrated to lower the risk of perioperative stroke, as well as reducing the risk of short-term mortality, renal failure, atrial fibrillation, bleeding, and length of intensive care unit stay. However, increased risk persists owing to the need for the tangential ascending aorta clamping to construct the proximal anastomosis. The concept of anaortic (aorta no-touch) OPCAB (anOPCAB) stems from eliminating ascending aorta manipulation, virtually abolishing the risk of embolism caused by aortic wall debris into the brain circulation. The adoption of anOPCAB has been shown to further decrease the risk of postoperative stroke, especially in higher-risk patients, entailing a step forward and a refinement of outcomes provided by the primeval OPCAB technique. Therefore, anOPCAB has been the recommended technique in patients with cerebrovascular disease and/or calciﬁcation or atheromatous plaque in the ascending aorta and should be preferred in patients with high-risk factors for neurological damage and stroke.

https://doi.org/10.21470/1678-9741-2020-0451 54 downloads

15.

Inspiratory Muscle Weakness is Related to Poor Short-Term Outcomes for Heart Transplantation
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Begot, Isis

; Gomes, Walter J.

; Rocco, Isadora S.

; Bublitz, Caroline

; Gonzaga, Laion R. A.

; Bolzan, Douglas W.

; Santos, Vinicius Batista

; Moreira, Rita Simone Lopes

; Breda, João R.

; Almeida, Dirceu Rodrigues de

; Arena, Ross

; Guizilini, Solange

Brazilian Journal of Cardiovascular Surgery

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jun 2021, Volume 36 N. 3 Pages 308 - 317

Abstract: En | Text: En | PDF: En

Abstract Introduction: In heart transplantation (HT) recipients, several factors are critical to promptly adopting appropriate rehabilitation strategies and may be important to predict outcomes way after surgery. This study aimed to determine preoperative patient-related risk factors that could adversely affect the postoperative clinical course of patients undergoing HT. Methods: Twenty-one hospitalized patients with heart failure undergoing HT were evaluated according to respiratory muscle strength and functional capacity before HT. Mechanical ventilation (MV) time, reintubation rate, and intensive care unit (ICU) length of stay were recorded, and assessed postoperatively. Results: Inspiratory muscle strength as absolute and percentpredicted values were strongly correlated with MV time (r=-0.61 and r=-0.70, respectively, at P<0.001). Concerning ICU length of stay, only maximal inspiratory pressure (MIP) absolute and percent-predicted values were significantly associated. The absolute |MIP| was significantly negatively correlated with ICU length of stay (r=-0.58 at P=0.006) and the percent-predicted MIP was also significantly negatively correlated with ICU length of stay (r=-0.68 at P=0.0007). No associations were observed between preoperative functional capacity, age, sex, and clinical characteristics and MV time and ICU length of stay in the cohort included in this study. Patients with respiratory muscle weakness had a higher prevalence of prolonged MV, reintubation, and delayed ICU length of stay. Conclusion: An impairment of preoperative MIP was associated with poorer short-term outcomes following HT. As such, inspiratory muscle strength is an important clinical preoperative marker in patients undergoing HT.

https://doi.org/10.21470/1678-9741-2020-0344 14 downloads

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