RESUMO:Estudo de coorte prospectivo, com objetivo de verificar a incidência de flebite em pacientes com cateter intravenoso periférico e identificar possíveis associações dessa complicação com variáveis relativas a estes cateteres. Foram avaliados 76 pacientes adultos internados em enfermaria de um hospital universitário, utilizando-se de uma ficha contendo variáveis relativas aos pacientes, ao cateter intravenoso periférico e à terapia farmacológica. A flebite foi avaliada segundo classificação proposta pela Infusion Nurses Society. Utilizou-se estatística descritiva e inferencial. Observou-se incidência de 25,8% de flebite, das quais 40% apresentaram manifestações clínicas de dor, com eritema e ou edema. Dentre os pacientes com flebite, 60% desenvolveram um episódio da complicação, e o tempo de permanência médio dos cateteres intravenosos periféricos com flebite foi de 3,10 dias. Constatou-se associação da flebite à retirada do cateter intravenoso periférico por ocorrência adversa (p<0,001). São necessárias ações educativas e capacitação da equipe de enfermagem para o manejo da terapia intravenosa, principalmente no que tange à detecção precoce da flebite. RElaTION bETWEEN pHlEbITIS aNd pERIpHERal INTRavENOUSCaTHETER REMOval abSTRaCT: The objective of this prospective study is to verify the incidence of phlebitis among patients with peripheral intravenous catheters and to identify possible relations between this complication and catheter-related variables. Seventy-six adult patients hospitalized in a Brazilian university hospital were evaluated, using charts with patient-related variables, peripheral intravenous catheters, and pharmacological therapy. Phlebitis was evaluated based on Infusion Nurses Society proposed classification. Inferential and descriptive statistics have been used. We observed 25.8% incidence of phlebitis, from which 40% presented pain occurrences, with erythema and edema. Among patients with phlebitis, 60% developed a complication episode, and the average period of permanence of peripheral intravenous catheters with phlebitis was 3.10 days. We observed phlebitis associations to adverse occurrences during the removal of peripheral intravenous catheters (p<0.001). Educational actions and professional training for nursing personnel are necessary for dealing with intravenous therapy, mainly on what is related to early detection of phlebitis.dESCRIpTORS: Intravenous infusions. Phlebitis. Nursing. Nursing care. Peripheral catheterization. RElaCIÓN ENTRE la FlEbITIS Y la RETIRada dE CaTéTERES INTRavENOSOS pERIFéRICOSRESUMEN: Se trata de un estudio prospectivo para determinar la incidencia de flebitis en pacientes con catéter intravenoso periférico e identificar posibles asociaciones de esta complicación con las variables relacionadas con el catéter intravenoso periférico. Se evaluaron setenta y seis pacientes adultos hospitalizados en el sector de enfermería de un hospital universitario, mediante un formulario que contiene las variables relacionadas con los pacientes, el catéter intravenoso per...
Background: The aim of this post hoc analysis of a large cohort study was to evaluate the association between night-time surgery and the occurrence of intraoperative adverse events (AEs) and postoperative pulmonary complications (PPCs). Methods: LAS VEGAS (Local Assessment of Ventilatory Management During General Anesthesia for Surgery) was a prospective international 1-week study that enrolled adult patients undergoing surgical procedures with general anaesthesia and mechanical ventilation in 146 hospitals across 29 countries. Surgeries were defined as occurring during 'daytime' when induction of anaesthesia was between 8:00 AM and 7:59 PM, and as 'night-time' when induction was between 8:00 PM and 7:59 AM. Results: Of 9861 included patients, 555 (5.6%) underwent surgery during night-time. The proportion of patients who developed intraoperative AEs was higher during night-time surgery in unmatched (43.6% vs 34.1%; P<0.001) and propensity-matched analyses (43.7% vs 36.8%; P¼0.029). PPCs also occurred more often in patients who underwent night-time surgery (14% vs 10%; P¼0.004) in an unmatched cohort analysis, although not in a propensity-matched analysis (13.8% vs 11.8%; P¼0.39). In a multivariable regression model, including patient characteristics and types of surgery and anaesthesia, night-time surgery was independently associated with a higher incidence of intraoperative AEs (odds ratio: 1.44; 95% confidence interval: 1.09e1.90; P¼0.01), but not with a higher incidence of PPCs (odds ratio: 1.32; 95% confidence interval: 0.89e1.90; P¼0.15). Conclusions: Intraoperative adverse events and postoperative pulmonary complications occurred more often in patients undergoing night-time surgery. Imbalances in patients' clinical characteristics, types of surgery, and intraoperative management at night-time partially explained the higher incidence of postoperative pulmonary complications, but not the higher incidence of adverse events. Clinical trial registration: NCT01601223.
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