Obst ructive Sleep Disorders (OSD) affect mostly the pediatric population. Within this group, its main etiology is adenotonsillar hyperplasia, being adenoidectomy or adenotonsillectomy the best treatment option for quality of life improvement. Aim: To asses quality of life of children with OSD after adenoidectomy/adenotonsillectomy. Method: A prospective study was carried out with 48 children, between 2 and 11 years, with clinical manifestations of OSD and obstructive adenotonsillar hyperplasia. The OSA18 questionnaire was answered by the parents to evaluate their children's quality of life before surgery; at about thirty days and at least eleven months after the procedure. A higher score meant a worse quality of life. Results: Before surgery, the average OSA18 score was 82.83(SD=12.57), with an average global score for quality of life of 6.04(SD=1.66). Within thirty days after surgery, the average OSA18 score was 34.3 (SD=9.95) with an average global score of 9.6(SD=0.81), both showing significant reduction (p< 0.001). Thirty-four children (70.83%) were re-evaluated between 11 and 30 months (average=16.85; SD=5.16). The average OSA18 score was 35.44 (SD=19.95) with an average global score of 9.28 (SD=1.78). The postoperative evaluations weren't significantly different. Conclusion: surgery improves the quality of life of children with OSD, and such improvement maintains for the long run.
RBCCV 44205-759Padronização da dose de heparina sódica utilizada na cirurgia de revascularização do miocárdio sem circulação extracorpórea Standardization of the sodium heparin dose used in off-pump myocardial revascularization surgery Abstract Objective: To evaluate a methodology of anticoagulation during off-pump coronary artery bypass surgery (CABS) that promotes safe anticoagulation during the procedure (Activated Coagulation Time (ACT) ≥ ≥ ≥ ≥ ≥ 200 seconds), using an initial dose of 1 mg of sodium heparin/kg weight.Method: 40 patients (30 men and 10 women), with ages ranging from 41 to 85 years, were submitted to off-pump CABS, using an initial sodium heparin dose of 1mg/kg of weight. Ten minutes after the drug was administered, if the ACT was = 200 seconds, we initiated the revascularization procedure. If not, we administered an additional dose of 0.5mg/ kg heparin. During the surgery, the ACT was measured at 30 minute intervals. After revascularization, heparin reversal was achieved with a dose of protamine chloride equal do the total heparin dose infused during the procedure (1:1). Conclusões: Os resultados apresentados demonstram a segurança e eficácia da anticoagulação monitorizada pelo TCA nos pacientes submetidos à RM sem CEC, utilizando doses de 1mg heparina sódica/kg de peso, capaz de manter-se efetiva durante todo o procedimento cirúrgico, independentemente de variáveis como sexo ou idade.
Results:Descritores: Revascularização miocárdica. Heparina. Tempo de coagulação do sangue total.
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