Data were compiled with Microsoft Excel and descriptive statistical analysis was performed, presenting the results in tables. A total of 104 subjects were interviewed, 36 were excluded after chart analysis, and 68 were included. Method: this is a quantitative, descriptive, exploratory, prospective and observational study carried out with records from the Hemodynamics sector. Objective: to identify the incidence of adverse events to iodinated contrast media in patients submitted to Coronary Angioplasty. Descritores : Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos Meios de Contraste Radiologia Intervencionista Enfermagem Pesquisa em Enfermagem Clínica Segurança do Paciente. Observou-se que não se relacionou fator causal principal e verificou-se que os eventos adversos constituem importantes indicadores da qualidade da assistência, sendo pertinente a sua prevenção. Conclusão : constatou-se que a prevalência de 4,4% de eventos está em consonância com a literatura. Resultados : identificaram-se três eventos adversos relacionados aos meios de contraste em três diferentes participantes, sendo dois do sexo masculino e um do sexo feminino, onde se utilizaram, respectivamente, 120, 130 e 450 mililitros de volume de contraste. Compilaram-se os dados com Microsoft Excel e realizou-se a análise estatística descritiva, apresentando os resultados em tabelas. Entrevistaram-se 104 indivíduos, excluíram-se 36 após a análise de prontuários e incluíram-se 68. Método : trata-se de um estudo quantitativo, descritivo, exploratório, prospectivo e observacional realizado com registros de um setor de Hemodinâmica. In elderly patients, diabetics and especially in patients with a serum creatinne higher than 1.5 mg/dl or a glomerular filtration rate lower than 60 ml/min as our patient, the risk is very high and even higher when the renal function is lower.Īcute renal failure xRay contrast media.Objetivo : identificar a incidência de eventos adversos a meios de contraste iodados em pacientes submetidos à angioplastia coronária. In patients with normal renal func-tion, serum creatine less than 1,5 mg/dl and a glomerular filtration rate higher than 60 ml/min, the risk is small and it is not necessary to take any especial precaution. Prevention includes the administration of small doses of contrast media, avoiding repeated studies in less than 72 hours avoiding fluid depletion and the administration of non steroid anti inflalory agents in the previous days or the day of the study hydration with normal satine or sodium bicarbonato the day before, the day of the study and one day later giving N-acetyl cisteine one day before and the day of the study and using if possible the most recent non ionic iso osmolar agents. Mortality in patients admitted to the Intensive Care Unit is higher when develop acute renal failure resulting from exposure to xRay contrast media and proporcional to APACHE score, reaching 62% in those with a score > than 12 against those without acute renal failure and a score < 3 in whom mortality is only 4%. The incidence is higher in patients with multiple riskfactors or a risk factor of great severity as in our patient. Exposure to xRay contrast media is the third cause of in hospital acute renal failure and has a mortality of 14%. The mechanism of nephrotoxicity incluyes renal vasoconstriction and medular hypoxemia induced by changes in nitric oxide, endothelin andior adenosine and a direct toxic effect. The risk of nephroloxicity is higher with ionic hyperosmolar agents and lower with those recently introduced iso osmolar and non ionic, especially in high risk patients as the one described. Serum creatinine on admision 4 mg/dl, raising to 7.1 two days after exposure and coming down to 35 mg/dl three weeks later. We present a 72 year old patient with coronary heart disease, type II diabetes mellitus, diabetic nephropathy, diabetic macrovascular disease and bleeding hemorroids, admitted for coronary angiogram before surgery for hemorroids. The exposure to xRay contrast media is followed hy a usually reversible acule renal failure, short time after. FALLO RENAL AGUDO INDUCIDO POR MEDIOS DE CONTRASTE RADIOLÓGICO: REVISIÓN BIBLIOGRAFICA A PARTIR DE UN CASO. ORTEGA MARTINEZ, Rommer Alex y SILVESTRE ARZE, Ricardo.
0 Comments
Leave a Reply. |