Análise da qualidade de vida após a alta hospitalar em sobreviventes de sepse grave e choque séptico

Westphal, Glauco Adrieno; Vieira, Kalinca Daberkow; Orzechowski, Roman; Kaefer, Keitiane; Zaclikevis, Viviane Renata; Mastroeni, Marco Fábio

doi:10.1590/s1020-49892012000600008

Cited by 15 publications

(40 citation statements)

References 32 publications

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“…In the individuals evaluated in our study, the time of MV was 14 (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) days and the mean length of stay in the ICU was 15.80±7.16 days, the number of medicines used was 11.87±2,32, evidencing that most of the patients were receiving ventilatory assistance. Therefore, they were more restricted to bed, a fact that may contribute to an increase in complications and in the use of medicines, which directly affects independence.…”

Section: Discussionmentioning

confidence: 70%

“…The most affected areas were functional capacity, limitation by physical aspects, pain and social aspects, and the less affected ones were general health, vitality, limitation by emotional aspects and mental health. A cross-sectional study (19) conducted at two ICUs, comparing 36 individuals with sepsis/septic shock and control subjects, also analyzed the QoL by means of the SF-36 and observed involvement in all areas of the questionnaire in the survivors' group, except in limitations due to emotional issues. These results demonstrate that ICU hospitalization and complications interfere directly with QoL after discharge.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of functionality and quality of life in critical patients: case series report

Wiethan¹,

Soares

Souza³

2017

Acta Fisiátrica

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Hospitalization in Intensive Care Unit (ICU) usually results in decreased functionality and quality of life. Risk long-term sequelae may result from factors related to disease, treatment performed and time staying in bed. Objective: To evaluate the functionality and quality of life of patients who received physiotherapy in the ICU and correlate these variables after 30 days of discharge. Methods: A case series report study was conducted with 15 patients. Evaluation of functionality by the Functional Independence Measure -FIM (before ICU, at immediate release and after 30 days), evaluation of quality of life by Short-Form (SF-36) Health Survey (after 30 days). Results: The mean age was 43.20 ± 16.92 years, predominant causes of hospitalization were neurological, mechanical ventilation time was 14 (9-14) days and ICU 15.80 ± 7.16 days and all had complications. Before the ICU the patients were with full or modified independence (FIM 1=126), after discharge there was a decline to modified dependence (FIM 2=48) and after 30 days there was improvement, but functionality continued as modified dependence (FIM 3=92). The functionality areas like self-care, mobility and locomotion had major changes after the ICU and a significant improvement at 30 days; sphincter control, communication and social cognition had minor changes after the ICU and after 30 days the values approached the previous ones. The quality of life was affected 30 days after discharge with reduction in scores for all areas, the most affected ones were functional capacity, limitation by physical aspects, pain and social aspects. There were positive correlations between the areas of sphincters control, mobility and mobility (functionality) and functional capacity (quality of life). Conclusion: ICU negatively affected the functionality, especially at immediate release. After 30 days, there was an improvement, in part, that can be attributed to physical therapy, because all patients received this treatment in the ICU and many continued it after discharge. However, some deficits still remained, also affecting their quality of life.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Evaluation of functionality and quality of life in critical patients: case series report

Wiethan¹,

Soares

Souza³

2017

Acta Fisiátrica

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“…Os prejuízos decorrentes da sepse vão além da alta mortalidade hospitalar, uma vez que pacientes que sobrevivem ao evento de sepse apresentam risco maior de óbito até cinco anos após a hospitalização (WESTPHAL et al, 2012;JAGODIČ;JAGODIČ;PODBREGAR, 2006;DAVIDSON et al, 1999). Além disso, podem apresentar prejuízos nos aspectos físicos e cognitivos, o que resulta em comprometimento físico, emocional e consequentemente social, que afetam a Qualidade de Vida Relacionada à Saúde (QVRS) desses indivíduos (SASSE et al, 1995).…”

Section: Introductionunclassified

“…Nos sobreviventes à sepse a taxa de mortalidade permanece elevada no primeiro ano após a alta hospitalar, sendo que o risco aumentado de morte pode persistir por, aproximadamente, cinco anos após a hospitalização (WESTPHAL et al, 2012;JAGODIČ;JAGODIČ;PODBREGAR, 2006;DAVIDSON et al, 1999). A letalidade a curto e em longo prazo parece estar associada às disfunções orgânicas ocorridas na fase aguda da doença.…”

Section: Introductionunclassified

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A experiência da sepse e a qualidade de vida relacionada à saúde: um diálogo entre a psicanálise e as ciências da saúde

Matioli¹

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Impaired vascular function in sepsis-surviving rats mediated by oxidative stress and Rho-Kinase pathway

et al. 2016

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We investigated long-lasting changes in endothelial and vascular function in adult rat survivors of severe sepsis induced by cecal ligation and puncture (CLP) model. For this, male Wistar rats (200–350 g) had their cecum punctured once (non-transfixing hole) with a 14-gauge needle. Performed in this way, a mortality rate around 30% was achieved in the first 72 h. The survivors, together with age-matched control rats (not subjected to CLP), were maintained in our holding room for 60 days (S60 group) and had the descending thoracic aorta processed for functional, histological, biochemical or molecular analyses. Endothelium-intact aortic rings obtained from sepsis-surviving S60 group displayed increased angiotensin II-induced contraction, accompanied by decreased activity of the endogenous superoxide dismutase, augmented reactive oxygen species generation, and increased levels of tyrosine nitration compared with vessels from control group. The superoxide scavengers superoxide dismutase and tempol, and the antioxidant apocynin, were able to avoid this enhanced contractility to angiotensin II in aortic rings from the S60 group. In addition, aortic rings from the S60 group presented reduced sensitivity to Y-27632, a Rho-kinase (ROCK) inhibitor. Immunoblot analyses revealed augmented RhoA and ROCK II, and high levels of phosphorylation of myosin phosphatase target subunit 1 in vessels from S60 rats. In conclusion, aortic rings from sepsis-surviving rats display endothelial dysfunction mediated by the increased production of reactive oxygen species, which in turn reduces the bioavailability of nitric oxide and increases the formation of peroxynitrite, and enhances RhoA-ROCK-mediated calcium sensitization, leading to augmented contractile responses to angiotensin II. Notably, this is the first study demonstrating long-term dysfunction in the vasculature of sepsis-surviving rats, which take place or remain beyond the acute septic insult.

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Análise da qualidade de vida após a alta hospitalar em sobreviventes de sepse grave e choque séptico

Abstract: Severe sepsis or septic shock can result in significant negative effects on the quality of life, in addition to reducing long-term survival probability.

Cited by 15 publications

References 32 publications

Evaluation of functionality and quality of life in critical patients: case series report

Evaluation of functionality and quality of life in critical patients: case series report

A experiência da sepse e a qualidade de vida relacionada à saúde: um diálogo entre a psicanálise e as ciências da saúde

Impaired vascular function in sepsis-surviving rats mediated by oxidative stress and Rho-Kinase pathway

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