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Moitinho MS, Silva Junior JRD, Cunha MDB, Barbosa DA, Caixeta AM, Pimpinato AG, Junglos AF, Belasco AGDS, Fonseca CDD. Contrast-induced acute kidney injury in patients submitted to coronary angioplasty: prospective cohort. Rev Esc Enferm USP 2022; 56:e20210435. [PMID: 35781323 DOI: 10.1590/1980-220x-reeusp-2021-0435en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/20/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the incidence, risk factors, and associations of clinical outcomes for contrast-induced acute kidney injury (CI-AKI) in patients with acute coronary syndrome (ACS) after coronary angioplasty. METHOD Prospective cohort of 182 patients followed for three months after undergoing angioplasty, from July 2020 to June 2021. The analyzed variables were sociodemographic, clinical, and those related to the procedure. RESULTS The incidence of CI-AKI was 35.7% (n = 65) and was associated with old age, diabetes mellitus, and chronic kidney disease (p = 0.004, p < 0.001, and p = 0.009, respectively). Out of the 17 patients who died within 90 days, 76.5% had CI-AKI (n = 13), the odds ratio between death and CI-AKI was approximately 7.2 times (95% confidence interval (CI), [2.41;26.36]; p = 0.001). The decrease of one unit in the patient's baseline hemoglobin showed a 6.5% increase for CI-AKI (95% CI, [-0.089; -0.040]; p < 0.0001). CONCLUSION CI-AKI is prevalent in patients with ACS after angioplasty and is related to diabetes mellitus and chronic kidney disease, showing high mortality rates.
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Affiliation(s)
- Matheus Santos Moitinho
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, Departamento de Enfermagem clínica e cirúrgica, São Paulo, SP, Brazil
| | - Jumar Reis Da Silva Junior
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, Departamento de Enfermagem clínica e cirúrgica, São Paulo, SP, Brazil
| | - Maximina De Barros Cunha
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, Departamento de Enfermagem clínica e cirúrgica, São Paulo, SP, Brazil
| | - Dulce Aparecida Barbosa
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, Departamento de Enfermagem clínica e cirúrgica, São Paulo, SP, Brazil
| | - Adriano Mendes Caixeta
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Cardiologia Intervencionista, São Paulo, SP, Brazil
| | - Attilio Galhardo Pimpinato
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Cardiologia Intervencionista, São Paulo, SP, Brazil
| | - Alana Francine Junglos
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, Departamento de Enfermagem clínica e cirúrgica, São Paulo, SP, Brazil
| | | | - Cassiane Dezoti da Fonseca
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, Departamento de Enfermagem clínica e cirúrgica, São Paulo, SP, Brazil.,Universidade Federal de Sergipe, Programa de Pós-Graduação em Enfermagem, São Cristóvão, SE, Brazil
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Moitinho MS, Silva Junior JRD, Cunha MDB, Barbosa DA, Caixeta AM, Pimpinato AG, Junglos AF, Belasco AGDS, Fonseca CDD. Lesão renal aguda induzida por contraste em pacientes submetidos à angioplastia coronariana: coorte prospectiva. Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2021-0435pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: Analisar a incidência, os fatores de risco e as associações dos desfechos clínicos para Lesão Renal Aguda Induzida Por Contraste (LRA-IC) em pacientes com Síndrome Coronariana Aguda (SCA) após angioplastia coronariana. Método: Coorte prospectivo de 182 pacientes seguidos por três meses após angioplastia, entre julho de 2020 e junho de 2021. As variáveis foram sociodemográficas, clínicas e relacionadas ao procedimento. Resultados: A incidência de LRA-IC foi de 35,7% (n = 65) e esteve associada à idade avançada, diabetes mellitus e doença renal crônica (respectivamente p = 0,004, p < 0,001 e p = 0,009). Dos 17 pacientes que faleceram em até 90 dias, 76,5% tiveram LRA-IC (n = 13), a razão de chances entre óbito e LRA-IC foi de aproximadamente 7,2 vezes (intervalo de confiança (IC) 95%, [2,41;26,36]; p = 0.001). A diminuição de uma unidade na hemoglobina basal do paciente demonstrou um aumento de 6,5% para LRA-IC (IC 95%, [–0,089; –0,040]; p < 0,0001). Conclusão: Em pacientes com SCA após angioplastia, a LRA-IC tem alta incidência e está relacionada com diabetes mellitus e doença renal crônica, apresentando altos índices de mortalidade.
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Moitinho MS, Santos ES, Caixeta AM, Belasco AGDS, Barbosa DA, Fonseca CDD. Contrast-Induced Nephropathy in patients submitted to percutaneous coronary intervention: an integrative review. Rev Bras Enferm 2020; 73:e20200190. [PMID: 33338170 DOI: 10.1590/0034-7167-2020-0190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 09/01/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE to demonstrate scientific evidence on incidence and factors associated with contrast-induced nephropathy in patients undergoing percutaneous coronary intervention. METHODS an integrative review carried out in the VHL, PubMed, VHL Regional Portal and SciELO databases, of articles published between 2014 and 2019. RESULTS the sample consisted of five original articles, two cohorts, two control cases and a clinical trial. The incidence of contrast-induced nephropathy ranged from 6% to 24%. It stands out among patients with advanced age, male gender, diabetes mellitus, systemic arterial hypertension, volume of contrast infused and osmolarity. Intravenous hydration, sodium bicarbonate, ascorbic acid and statin were important prophylactic agents. CONCLUSION this study envisioned the main risk factors for contrast-induced nephropathy in patients undergoing percutaneous coronary intervention and elucidated preventive measures that guide multidisciplinary health care aiming at a quality and safe care.
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Juchem BC, Almeida MDA, Lucena ADF. [New nursing diagnoses in imaging: submission to NANDA International]. Rev Bras Enferm 2010; 63:480-6. [PMID: 20658087 DOI: 10.1590/s0034-71672010000300022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Accepted: 11/04/2009] [Indexed: 11/22/2022] Open
Abstract
The present work reports the experiment on the creation and submission to North American Nursing Diagnosis Association International (NANDA-I) of Nursing Diagnosis in the imageology area: "Adverse Reaction to Iodinated Contrast Media" and "Risk of Adverse Reaction to Iodinated Contrast Media". For this experiment the method of integrative revision of literature was utilized associated with the experience in clinical practice. The document for submission was elaborated according to guidance offered by NANDA-I and sent for appreciation to the Diagnosis Development Committee. The risk diagnose was approved and the real diagnose is still in evaluation process by the Diagnosis Development Committee. With this experiment we hope to motivate Brazilian nurses to contribute to the taxonomy of NANDA-I and participate in the building ofnursing knowledge.
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Affiliation(s)
- Beatriz Cavalcanti Juchem
- Grupo de Estudo e Pesquisa em Enfermagem no Cuidado ao Adulto e Idoso, Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS.
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Juchem BC, Dall'Agnol CM. Immediate adverse reactions to intravenous iodinated contrast media in computed tomography. Rev Lat Am Enfermagem 2007; 15:78-83. [PMID: 17375236 DOI: 10.1590/s0104-11692007000100012] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2006] [Accepted: 05/24/2006] [Indexed: 11/21/2022] Open
Abstract
This exploratory-descriptive, non-experimental quantitative research aimed to learn about immediate adverse reactions to intravenous iodinated contrast media in hospitalized patients submitted to computed tomography at a teaching hospital in the South of Brazil. During the study period, all adverse reactions showed mild intensity, at a frequency of 12.5% with ionic iodinated contrast media, and 1% with non-ionic contrast agent. The extravasation of contrast occurred in 2.2% of the injections in a peripheral vein without complications in any of the cases. The results are within the limits cited in international literature and suggest that tomography service professionals should know their own rates of adverse reactions to iodinated contrast agent, as well as the conditions in which they occur, in order to obtain evidence to evaluate the respective care delivery processes.
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