CIAC, Anestesiologia

Dr Ranger Cavalcante contribuiu na tradução do Manual de Emergência de Stanford.
Referência ➡️
https://emergencymanual.stanford.edu/other-languages/

📣 Controversies in enhanced recovery after cardiac surgery.

https://www.linksmedicus.com/news/controversies-enhanced-recovery-cardiac-surgery/

Background: 30–80% of patients being treated in intensive care units in the perioperative period develop hyperglycemia. This stress hyperglycemia is induced and maintained by inflammatory-endocrine and iatrogenic stimuli and generally requires treatment. There is uncertainty regarding the optimal blood glucose targets for patients with diabetes mellitus.

Methods: This review is based on pertinent publications retrieved by a selective search in PubMed and Google Scholar.

Results: Patients in intensive care with pre-existing diabetes do not benefit from blood sugar reduction to the same extent as metabolically healthy individuals, but they, too, are exposed to a clinically relevant risk of hypoglycemia. A therapeutic range from 4.4 to 6.1 mmol/L (79–110 mg/dL) cannot be justified for patients with diabetes mellitus. The primary therapeutic strategy in the perioperative setting should be to strictly avoid hypoglycemia. Neurotoxic effects and the promotion of wound-healing disturbances are among the adverse consequences of hyperglycemia. Meta-analyses have shown that an upper blood sugar limit of 10 mmol/L (180 mg/dL) is associated with better outcomes for diabetic patients than an upper limit of less than this value. The target range of 7.8–10 mmol/L (140–180 mg/dL) proposed by specialty societies for hospitalized patients with diabetes seems to be the best compromise at present for optimizing clinical outcomes while avoiding hypoglycemia. The method of choice for achieving this goal in intensive care medicine is the continuous intravenous administration of insulin, requirng standardized, high-quality monitoring conditions.

Conclusion: Optimal blood sugar control for diabetic patients in intensive care meets the dual objectives of avoiding hypoglycemia while keeping the blood glucose concentration under 10 mmol/L (180 mg/dL). Nutrition therapy in accordance with the relevant guidelines is an indispensable prerequisite.

Referência:
https://www.aerzteblatt.de/int/archive/article/221208

Feliz Natal e um Próspero 2022!
Que possamos desfrutar de grandes momentos em companhia de todos que nos fazem bem! Nossos, Parceiros, Amigos, Colaboradores, Anestesistas, Familiares, etc.

Curso de Ecocardiografia Transesofágica no Intraoperatório, ETTI.
SBA, Sociedade Brasileira de Anestesiologia.
Rio de Janeiro, Dezembro de 2021.
sociedade

Importância da consulta pré anestésica na programação cirúrgica. Agende a sua consulta.
CIAC, Clínica de Anestesiologia de Curitiba.

Aprovado no TSA, 2021.
Dr.Rafael Drabik.
Anestesista CIAC,
IQG Diamante.

Cirurgia para tratamento de Nasoangiofibroma Juvenil (NAJ).
Anestesia Venosa Total.
Time cirurgiões:
Dr Fábio, Dr Renato, Dr Matheus
Anestesista: Dr Rafael Drabik
Instrumentadora:Sandra
Enfermagem: Thaísia
Hospital das Nações,
Novembro de 2021.

Delirium em Anestesiologia,
BJA, Agosto de 2021.
Referência:

https://www.bjanaesthesia.org/article/S0007-0912(21)00493-1/fulltext

Quem Somos?
Nosso time administrativo, em foto.
Nosso objetivo ? “-entregar valor e facilidades para nossos pacientes, cirurgiões e colaboradores. “
Ciac, 2021.