Introduction: Neurological dysfunction is a feared postoperative morbidity of cardiac surgery, an important cause of death and increased spending in hospitals. Its prediction, however, is still uncertain.Objective: To assess the applicability of a preoperative score as a predictor of neurological dysfunction after coronary artery bypass grafting (CABG) under cardiopulmonary bypass (CPB).Methods: Prospective study that evaluated 77 patients who underwent CABG from February to October 2011. Using the score CABDEAL (creatinine, age, body mass index, diabetes, emergency surgery, abnormality on ECG, lung disease), patients were grouped into high (CABDEAL > 4) and low risk (CABDEAL<4). The predictive value of the score was compared with intraoperative and postoperative variables (aortic clamping time, CPB and ventilation time) as predictors of encephalopathy and stroke. Data were analyzed with descriptive statistics and compared with the Fisher exact test. ROC curve analysis was performed to evaluate the accuracy of the model for the neurological outcomes. It was considered the significant value P<0.05.Results: The mortality rate was 2.6% (n=2). There were 2 episodes of stroke (2.6%) and 12 (15.5%) of encephalopathy. High risk CABDEAL (P=0.0009), ventilation time (P=0.014), CPB time (P=0.02) and aortic clamping time (P=0.006) were significantly associated with encephalopathy. The aortic clamping time was also associated with stroke (P=0.03) and Assesment of CABDEAL score as predictor of neurological dysfunction after on-pump coronary artery bypass grafting surgery Bras Cir Cardiovasc 2012;27(3):429-35 death (P=0.006). CABDEAL score showed the largest area under the ROC curve rather than others variables.CABDEAL score as predictor of neurological dysfunction after on-pump coronary artery bypass grafting surgery RevConclusion: In this study, the CABDEAL score stood out as the best predictor of encephalopathy after CABG when compared to the others intraoperative variables.Keywords: Myocardial revascularization. Risk assessment. Morbidity. Brain damage. Resumo Introdução: As complicações neurológicas são temidas no pós-operatório das cirurgias cardíacas, sendo importante causa de óbito e de gastos hospitalares. Sua predição ainda é incerta.Objetivo: Avaliar a aplicabilidade de um escore pré-operatório como preditor de disfunção neurológica no pós-operatório de revascularização miocárdica (RM) com circulação extracorpórea (CEC). Métodos

Introduction Many authors have written about the need to treat patients closer to their beds, in order to observe them more as distinct people. The FAST HUG mnemonic, which consists of a checklist, was suggested as an idea to be employed everyday, by professionals dealing with patients who are critically ill. Minding these questions and motivated by an idea of follow patients' treatment closer, we have put into practice the instrument developed by Jean-Louis Vincent, evaluating the seven most important procedures in critically ill patients, and performed the FAST HUG. This checklist consists of seven items to be evaluated: Feeding, Analgesia, Sedation, Thromboembolic prophylaxis, Head-of-bed elevation, stress Ulcer prevention, and Glucose control. Knowing that the pressure ulcer is one of the challenges faced by ICU nurses, related to patients' need to stay at rest, to be under rigorous control or more complex therapy, it was decided to create the eighth item on the checklist: S, for skin. It stands for skin treatment, with the techniques used in the unit (Braden Scale), monitoring and evaluating closer skin integrity, and allowing nurses to calculate the scoring average of the Braden Scale, and greater incidence of ulcer in interned patients. Objective To expose the shortcomings found during the FAST HUG application, and to show results obtained with the eighth item of the FAST HUG mnemonic: S-Skin. Methods A descriptive study, based on institutional data, was carried out in the adult ICU of a private hospital. It was performed from 2 to 27 June 2008, except on weekends. Three hundred and twenty-three patients were involved. The checklist was carried out during the afternoons by the head nurse, or the assistant nurse of the unit. In order to do this job, a spreadsheet was elaborated to control data, updated every week. This spreadsheet provided graphics for a more objective control of the results obtained. The idea was exposed to the team, during a training program, and so we started the activities. Results and discussion For 20 days of the checklist, 323 patients were evaluated for the eight items. The real shortcomings most frequently found were related to thromboembolic prophylaxis (85%) and glucose control (90%). These shortcomings were immediately evaluated and, depending on this analysis, this item would go on or not, according to the patient's clinical situation. The shortcomings found were tracked just as they were detected, and their cause would be discussed in a multidisciplinary group, and a solution was found. If the item was not observed, it would be 1. Vincent JL: Give your patient a fast hug (at least) once a day.