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ABSTRACT: Hypomagnesemia has been linked with increased morbidity and mortality in critically ill patients. Since the condition is common after cardiopulmonary bypass surgery, the objective of this study was to determine whether magnesium supplementation in the immediate postoperative period may improve outcomes of patients undergoing cardiac surgery with cardiopulmonary bypass. This prospective, randomized, double-blind, placebo-controlled study was conducted in a third-level, cardiac surgery intensive care unit (ICU) at a university hospital. Two hundred and sixteen patients undergoing elective cardiac surgery with cardiopulmonary bypass were randomized to receive either an intravenous bolus of 1.5 g of magnesium sulphate followed by an infusion of 12 g of the same salt in 24 h (105 patients), or placebo (111 patients) administered according to the same schedule as the treatment group. No significant differences were found either in the primary end point (hours of intubation) or in the secondary end points (length of inotropic support, new atrial fibrillation, ventricular tachycardia or ventricular fibrillation, length of intensive care unit stay, or ICU or hospital mortality). Hypomagnesemia was present in 12% of patients on admission to the intensive care unit. The magnesium group had a greater need for pacemaker stimulation. In conclusion, under the conditions of the present study, magnesium supplementation after cardiac surgery with cardiopulmonary bypass does not favourably affect clinical outcomes.
Magnesium research: official organ of the International Society for the Development of Research on Magnesium 12/2012; · 1.52 Impact Factor
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ABSTRACT: OBJECTIVES
Cirrhosis represents a serious risk in patients undergoing cardiac surgery. Several preoperative factors identify cirrhotic patients as high risk for cardiac surgery; however, a patient's preoperative status may be modified by surgical intervention and, as yet, no independent postoperative mortality risk factors have been identified in this setting. The objective of this study was to identify preoperative and postoperative mortality risk factors and the scores that are the best predictors of short-term risk.METHODS
Fifty-eight consecutive cirrhotic patients requiring cardiac surgery between January 2004 and January 2009 were prospectively studied at our institution. Forty-two (72%) patients were operated on for valve replacement, 9 (16%) for a CABG and 7 (12%) for both (CABG and valve replacement). Thirty-four (58%) patients were classified as Child-Turcotte-Pugh class A, 21 (36%) as class B and 3 (5%) as class C. We evaluated the variables that are usually measured on admission and during the first 24 h of the postoperative period together with potential operative predictors of outcome, such as cardiac surgery scores (Parsonnet, EuroSCORE), liver scores (Child-Turcotte-Pugh, model for end-stage liver disease, United Kingdom end-stage liver disease score) and ICU scores (acute physiology and chronic health evaluation II and III, simplified acute physiology score II and III, sequential organ failure assessment).RESULTSSeven patients (12%) died in-hospital, of whom 5 were Child-Turcotte-Pugh class B and 2 class C. Comparing survivors vs non-survivors, univariate analysis revealed that variables associated with short-term outcome were international normalized ratio (1.5 ± 0.24 vs 2.2 ± 0.11, P < 0.0001), presurgery platelet count (171 ± 87 vs 113 ± 52 l nl(-1), P = 0.031), presurgery haemoglobin count (11.8 ± 1.8 vs 10.2 ± 1.4 g dl(-1), P = 0.021), total need for erythrocyte concentrates (2 ± 3.4 vs 8.5 ± 8 units, P < 0.0001), PaO(2)/FiO(2) at 12 h after ICU admission (327 ± 84 vs 257 ± 78, P = 0.04), initial central venous pressure (11 ± 3 vs 16 ± 4 mmHg, P = 0.02) and arterial blood lactate concentration 24 h after admission (1.8 ± 0.5 vs 2.5 ± 1.3 mmol l(-1), P = 0.019). Multivariate analysis identified initial central venous pressure as the only independent factor associated with short-term outcome (P = 0.027). The receiver operating characteristic curve showed that the model for end-stage Liver disease score had a better predictive value for short-term outcome than other scores (AUC: 90.5 ± 4.4%; sensitivity: 85.7%; specificity: 83.7%), although simplified acute physiology score III was acceptable.CONCLUSIONS
We conclude that central venous pressure could be a valuable predictor of short-term outcome in patients with cirrhosis undergoing cardiac surgery. The model for end-stage liver disease score is the best predictor of cirrhotic patients who are at high risk for cardiac surgery. Sequential organ failure assessment and simplified acute physiology score III are also valuable predictors.
Interactive cardiovascular and thoracic surgery 12/2012;
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ABSTRACT: Severe lithium poisoning is a frequent condition in the intoxicated intensive care unit population. Dialysis is the treatment of choice, but no clinical markers predicting higher requirement for dialysis have been identified to date. We analyze the characteristics of lithium overdose patients needing dialysis to improve lithium clearance, and identify the ones associated with higher dialysis requirement. This is an observational, retrospective study of 14 patients with lithium poisoning admitted from 2004 to 2009. Median age was 41.8 ± 16.1 years. Poisonings were acute in 7.1%, acute-on-chronic in 64.28%, and chronic in 28.5% of cases. Comparing clinical and biochemical data in patients requiring more than one dialysis session with those requiring only one session, the univariate analysis showed differences at admission in creatinine clearance (40.5 ± 23 vs. 73.3 ± 24.9 mL/min, P = 0.025), white blood cells (17,528 ± 3,530 vs. 11,580 ± 3360 cells/L, P = 0.007), and blood sodium concentration (134.8 ± 5.9 vs. 141.8 ± 8.4 mmol/L, P=0.035). We measured the degree of association between the number of sessions and the variables with partial correlations. High lithium levels (P = 0.006, r = 0.69), low creatinine clearance (P = 0.04, r = -0.55), and low blood sodium concentration (P = 0.024, r = -0.59) were associated with a greater number of dialysis sessions. The correlation remained significant for blood sodium concentration (P = 0.016, r = -0.67) after adjustment for creatinine clearance and initial lithium levels. Presence on admission of low creatinine clearance, low blood sodium concentration, and/or high lithium levels correlated with a higher number of dialysis sessions in severe lithium poisoning. These factors, especially low blood sodium concentration, are associated with higher dialysis requirements in severe lithium intoxication.
Hemodialysis International 07/2012; 16(3):407-13. · 1.54 Impact Factor
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ABSTRACT: We investigate age and sex differences in acute myocardial infarction (AMI) after cardiac surgery in a prospective study of 2038 consecutive patients undergoing cardiac surgery with cardiopulmonary bypass. An age of ≥ 70 years implied changes in the type of AMI from the ST-segment elevation myocardial infarction (STEMI) to non-ST-segment elevation myocardial infarction (non-STEMI). Men were more likely than women to suffer from AMI after cardiac surgery (11.8% vs. 5.6%), as a result of the higher frequency of STEMI (6% of men vs. 1.8% of women; P < 0.001) in both age groups. A troponin-I (Tn-I) peak was significantly higher in patients ≥ 70 years old. In-hospital mortality was higher in patients ≥ 70 (7.3%) than in those < 70 years old (3.3%), because of the increased mortality observed in men with non-AMI (2.1% vs. 6.3%) and women with STEMI (0% vs. 28.6%) and non-STEMI (0% vs. 36.8%, P < 0.05). Old age was associated with a higher frequency of non-STEMI, Tn-I peak, mortality and length of stay in the intensive care unit (ICU). Regardless of age, men more often suffer from AMI (particularly STEMI). AMI in women had a notable impact on excess mortality and ICU stay observed in patients ≥ 70 years of age. Clinical and Tn-I peak differences are expected in relation to age and gender after AMI post-cardiac surgery.
Interactive cardiovascular and thoracic surgery 04/2012; 15(1):28-32.
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ABSTRACT: The quality of dyadic adjustment is likely to play an important role in patients' relational problems and may also be associated with the clinical presentation of chronic fatigue syndrome (CFS) symptoms. The objective of this study was (1) to determine whether CFS patients and their partners have similar perceptions of their dyadic adjustment and (2) to evaluate whether the influence of dyadic satisfaction in women with CFS, as well as common psychological parameters such as anxiety, may correlate with physiological responses at rest and/or when performing very low intensity exercise. Forty females with CFS and their partners completed the Dyadic Adjustment Scale, the State-Trait Anxiety Inventory, and the Hospital Anxiety and Depression scale. The cardiovascular adaptation of patients was evaluated during resting conditions and on a precalibrated cycle ergometer while performing very low intensity exercise. Patients and partners had similar perceptions of their marital relationship. Both at rest and during very low workload, various physiological parameters in the patient group showed statistical correlations with certain psychological parameters. Several psychological variables, such as anxiety and dyadic adjustment, were associated with the cardioventilatory response monitored at rest and during very low intensity exercise. Further studies are needed to determine the nature of this association.
Psychology Health and Medicine 07/2011; 17(2):150-63. · 1.18 Impact Factor
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ABSTRACT: Resumen Objetivos: describir el proceso terapéutico y la posible influencia de las neuronas espejo en la empatía kinestésica empleando la terapia a través de la danza y el movimiento en el cáncer de mama. Método: se utilizó un estudio de caso. Una paciente diagnosticada con cáncer de mama desde hace dos años fue derivada al Depar-tamento de Ciencias fisiológicas II de la Uni-versidad de Barcelona. Ella asistió a una inter-vención con terapia a través de la danza y el movimiento durante 5 meses (1 hora semanal, 20 sesiones). Su historia clínica y las anotacio-nes tanto de ella como del terapeuta fueron revisadas. Resultado: La paciente mostró una mejora en su bienestar psicofísico percibido después de participar en el programa de terapia a tra-vés de la danza y el movimiento. Este tipo de intervención facilitó la recogida de informa-ción tanto a nivel físico como psicológico de la paciente. El proceso empático fue relevante para ello. Conclusiones: El bienestar percibido y expresado por la paciente a lo largo de las sesiones permite entrever la importancia clí-nica de la terapia a través de la danza y el movimiento. Una futura propuesta sería reali-zar dicha intervención en un contexto grupal, ampliando y diversificando el proceso empá-Abstract Objectives: To describe the therapeutic process and possible influence of mirror neurons in kinesthetic empathy using dance movement therapy for breast cancer. Method: Case study methodology was used. A patient diagnosed with breast cancer two years previously was referred to the Department of Physiological Sciences II, University of Barcelona. She attended a dance movement therapy intervention for 5 months (1 hour per week, 20 sessions).The patient's medical history and a therapist's records were reviewed. Result: The patient showed an improvement in perceived mental and physical well-being after participating in the program of dance movement therapy. This type of intervention facilitated the collection of physical and psychological patient information. Empathy was vital to this process. Conclusions: The perceived well-being expressed by the patient throughout the sessions enhances the clinical significance of dance movement therapy. It is recommended that a trial is undertaken to assess the effectiveness of dance movement therapy on breast cancer patients' mental and physical well-being.
01/2011; 8:31-43.
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Andrea Suárez,
Elisabet Guillamó,
Teresa Roig,
Alicia Blázquez,
José Alegre,
Jordi Bermúdez,
José Luis Ventura,
Ana María García-Quintana,
Agustí Comella,
Ramon Segura, Casimiro Javierre
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ABSTRACT: Chronic fatigue syndrome (CFS) is a disabling illness of unknown etiology that is characterized by fatigue associated with a reduced ability to work, lasting for more than 6 months, and accompanied by a specific set of symptoms. The diagnosis remains difficult because of the absence of laboratory tests and is, therefore, made largely on the basis of the symptoms reported by the patient. The aim of this study was to analyze differences in blood nitrate levels in CFS patients and a matched control group after a physical exercise test.
Forty-four consecutive female patients with CFS and 25 healthy women performed an exercise test using a cycle ergometer with monitoring of cardiopulmonary response. Blood samples were obtained for biochemical analyses of glucose, lactate, and nitrates at the beginning (under resting conditions) and after the maximal and supramaximal tests.
Plasma nitrates differed between the groups, with higher values in the CFS group (F = 6.93, p = 0.003). Nitrate concentration increased in relation to workload and reached higher values in the CFS group, the maximum difference with respect to the control group being 295% (t = 4.88, p < 0.001).
The main result of the present study is that nitric oxide (NO) metabolites (nitrates) showed a much higher increase after a maximal physical test in CFS patients than in a group of matched subjects. This combination (exercise plus NO response evaluation) may be useful in the assessment of CFS.
Journal of Women s Health 06/2010; 19(6):1073-7. · 1.57 Impact Factor
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ABSTRACT: To determine whether there are sex-based differences in serum troponin I (TnI) after cardiac surgery with cardiopulmonary bypass.
Prospective, observational, cohort study.
Tertiary cardiac surgery intensive care unit (ICU) at a university hospital.
None.
Serum TnI was measured in samples obtained at ICU admission and 6, 12, 24, and 48 hours later. A total of 761 consecutive patients were studied (444 men and 317 women). The characteristics and results of the different sex subgroups were as follows:A) Coronary bypass: 165 men and 38 women. Age, Parsonnet score, Acute Physiology and Chronic Health Evaluation III score, prevalence of renal failure, intra-aortic balloon use, and the lengths of cardiopulmonary bypass, mechanical ventilation, and ICU stay were similar in the two groups. Body mass index, red-cell transfusion needs, and use of noradrenaline were significantly higher in women, whereas dobutamine requirements were higher in men. Mortality: 3 men (1.6%) vs. 0 women (p = not significant).The TnI peak was slightly, but significantly, higher in men (6.2 +/- 4.9 vs. 4.5 +/- 2.6 microg/L. p < 0.05).B) Valve surgery: 279 men and 279 women. Some significant differences were found: Women were older than men and had higher Parsonnet score and transfusion needs. The other recorded variables were similar. Mitral prosthesis: 62 men and 125 women (p < 0.05). Mitral valvuloplasty: 24 men, 7 women (p < 0.05). Aortic prosthesis: 162 men, 103 women (p < 0.05). Mitral and aortic prosthesis: 31 men and 44 women (p < 0.05). TnI peaks were similar for both sexes in each valve subgroup. Mortality: 3 men (1%) vs. 11 women (3.4%) (p < 0.05).The TnI peak did not reach any significant differences between sexes (men 7.9 +/- 6.0 vs. 8.5 +/- 6.5 microg/L in women. p = not significant).
No clinically relevant sex-based differences were found in the TnI peaks after cardiac surgery.
Critical care medicine 07/2009; 37(7):2210-5. · 6.37 Impact Factor
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ABSTRACT: To identify associations among haemoglobin (Hb) concentrations, blood transfusions, and clinical outcomes in patients after cardiac surgery, especially in those who undergo valve replacement or bypass surgery.
Prospective observational trial.
Surgical intensive care unit in a tertiary-level university hospital.
1216 Consecutive patients.
Haemoglobin at admission and 6, 12, 24, and 48 h later, and then, every 24 h while patients remained in the intensive care unit (ICU); number of transfusions and clinical events.
Patients were divided into quartiles according to minimal haemoglobin, the first and second of which (Hb <8.10 and <8.91 g/dL, respectively) differed significantly (P < 0.001) from the other two quartiles in terms of more organ failure, longer ICU stay, and higher mortality. We found associations between being transfused >or=4 packed red cells (PRCs) and a worse clinical outcome and higher mortality. The associated mortality rate was higher for patients who underwent bypass surgery when they had Hb <or=8.9 g/dL and for those who underwent valve replacement when they had Hb >8.9 g/dL and were transfused >or=4 PRCs.
Low haemoglobin concentrations and transfusions in patients undergoing cardiac surgery are associated with increased morbidity and mortality. Also, anemia and transfusions are associated with poor outcome. Therefore, intra- and postoperative bleeding seem to be a risk factor in patients undergoing cardiac surgery.
European Journal of Intensive Care Medicine 06/2009; 35(9):1548-55. · 5.17 Impact Factor
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ABSTRACT: To analyse the association between individual initial computerized tomography (CT) scan characteristics and Glasgow Outcome Scale (GOS) and Extended Glasgow Outcome Scale (GOSE) improvement between 6 months and 1 year.
Two hundred and twenty-four adult patients with severe traumatic brain injury and Glasgow Coma Scale (GCS) score of 8 or less who were admitted to an intensive care unit were studied. GOS and GOSE scores were obtained 6 and 12 months after injury in 203 subjects. Patients were predominantly male (84%) and median age was 35 years.
Traumatic Coma Data Bank (TCDB) CT classification was associated with GOS/GOSE improvement between 6 months and 1 year, with diffuse injury type I, type II and evacuated mass improving more than diffuse injury type III, type IV and non-evacuated mass; for GOS 43/155 (28%) vs 3/48 (6%) (chi(2) = 9.66, p < 0.01) and for GOSE 71/155 (46%) vs 7/48 (15%) (chi(2) = 15.1, p < 0.01). CT individual abnormalities were not associated with GOS/GOSE improvement, with the exception of subarachnoid haemorrhage, which showed a negative association with GOSE improvement (chi(2) = 4.08, p < 0.05).
TCDB CT scan classification and subarachnoid haemorrhage were associated with GOS/GOSE improvement from 6-12 months, but individual CT abnormalities were not associated.
Brain Injury 03/2009; 23(5):403-10. · 1.36 Impact Factor
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ABSTRACT: The purpose of this study was to determine the possible correlation between inflammatory activation after cardiac surgery with cardiopulmonary bypass, measured by postoperative C-reactive protein concentrations, and immediate intensive care unit outcome.
A prospective, clinical cohort study.
A 10-bed surgical intensive care unit at a tertiary university hospital.
Two hundred sixteen consecutive patients undergoing nonemergency cardiac surgery with cardiopulmonary bypass.
Parsonnet and Acute Physiology and Chronic Health Evaluation scores, characteristics of the surgical intervention, intensive care unit length of stay, and mortality were recorded along with the following variables: cardiac (hours requiring inotropic support and new atrial fibrillation), respiratory (oxygenation index and hours requiring intubation), renal (difference between serum creatinine at admission and maximum creatinine), and analytic (C-reactive protein at admission and 6, 24, and 48 hours later; troponin I; CK-MB; and lactate).
Postoperative C-reactive protein concentrations did not correlate with variables such as time requiring inotropic support or intubation, oxygenation index, delta serum creatinine, and intensive care unit length of stay (with the exception of cardiopulmonary bypass time and the more frequent norepinephrine requirement in patients with higher C-reactive protein concentration at 48 hours); nor did C-reactive protein correlate with the analytic variables (with the exception of the lactate peak and C-reactive protein concentrations at 24 and 48 hours). There was no correlation between C-reactive protein and postoperative variables for coronary artery bypass graft surgery and valvular groups analyzed separately.
Postoperative C-reactive protein does not seem to be a useful marker in predicting outcome after 48 hours in the intensive care unit.
Journal of cardiothoracic and vascular anesthesia 03/2009; 23(2):166-9. · 1.06 Impact Factor
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ABSTRACT: Our goal was to determine whether short-term intermittent hypoxia exposure, at a level well tolerated by healthy humans and previously shown by our group to increase EPO and erythropoiesis, could mobilize hematopoietic stem cells (HSC) and increase their presence in peripheral circulation.
Four healthy male subjects were subjected to three different protocols: one with only a hypoxic stimulus (OH), another with a hypoxic stimulus plus muscle electrostimulation (HME) and the third with only muscle electrostimulation (OME). Intermittent hypobaric hypoxia exposure consisted of only three sessions of three hours at barometric pressure 540 hPa (equivalent to an altitude of 5000 m) for three consecutive days, whereas muscular electrostimulation was performed in two separate periods of 25 min in each session. Blood samples were obtained from an antecubital vein on three consecutive days immediately before the experiment and 24 h, 48 h, 4 days and 7 days after the last day of hypoxic exposure.
There was a clear increase in the number of circulating CD34+ cells after combined hypobaric hypoxia and muscular electrostimulation. This response was not observed after the isolated application of the same stimuli.
Our results open a new application field for hypobaric systems as a way to increase efficiency in peripheral HSC collection.
Journal of Translational Medicine 01/2009; 7:91. · 3.41 Impact Factor
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ABSTRACT: Nuts contain significant amounts of essential micronutrients that are associated with an improved health status when consumed at doses beyond those necessary to prevent deficiency states. Nuts do not contain cholesterol, but they are rich in chemically related phytosterols, a class of compounds that interfere with intestinal cholesterol absorption and thus help lower blood cholesterol. Nuts also contain folate, a B-vitamin necessary for normal cellular function that plays an important role in detoxifying homocysteine, a sulphur-containing amino acid with atherothrombotic properties that accumulates in plasma when folate status is subnormal. Compared to other common foodstuffs, nuts have an optimal nutritional density with respect to healthy minerals, such as calcium, magnesium and potassium. Like that of most vegetables, the sodium content of nuts is very low. A high intake of calcium, magnesium and potassium, together with a low sodium intake, is associated with protection against bone demineralisation, arterial hypertension, insulin resistance, and overall cardiovascular risk. Phytosterols might justify part of the cholesterol-lowering effect of nut intake beyond that attributable to fatty acid exchange, while the mineral richness of nuts probably contributes to the prevention of diabetes and coronary heart disease observed in epidemiological studies in association with frequent nut consumption.
British Journal Of Nutrition 12/2006; 96 Suppl 2:S36-44. · 3.01 Impact Factor
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ABSTRACT: Although we are far from a universally accepted pattern of impaired function at altitude, there is evidence indicating motor, perceptual, memory and behavioural deficits in adults. Even relatively low altitudes (2500 m) may delay reaction time, and impair motor function. Extreme altitude exposure (>5000 m) may result in more pronounced impairment that can persist after returning to the lowlands. Research into the effects of altitude exposure earlier in development is lacking by comparison. Un-acclimatized children can suffer from acute mountain sickness, and, in native populations born at altitude, subtle cognitive and behavioural deficits suggest incomplete adaptation to hypoxia. The study of neurobehavioural functioning at altitude may provide important information about the effects of clinical hypoxia on the human brain and behavioural development.
Developmental Science 08/2006; 9(4):400-10. · 3.89 Impact Factor
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High Altitude Medicine & Biology 02/2003; 4(2):259-60. · 1.77 Impact Factor
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ABSTRACT: There is a disparity in the information about the heritability of the response of muscle anaerobic metabolism to exercise and the use of explosive power, as well as a lack of information concerning the genetic determinants of this form of work, as measured using different specific physical tests. We applied a battery of some of the commonly employed procedures (Ergojump, Wingate, maximal accumulated oxygen deficit, excess post-exercise oxygen consumption, and delta lactate concentration) to a group of 32 Caucasian male twins, 8 monozygotic and 8 dizygotic pairs, who had similar environmental backgrounds. Results were studied using a heritability index (HI). Zygosity was determined using the identity of erythrocyte antigens, protein and enzyme polymorphism and human leucocyte antigen serologic types between co-twins. Significant HI values (P< 0.05) were found in the following tests: maximal 5 s power (HI = 0.74) and total power in a 30 s interval (HI = 0.84) in the Wingate test, maximal lactate concentration (HI = 0.82) and delta lactate concentration (HI = 0.84) in the maximal progressive test, as well as in the 2nd (HI = 0.93) and in the 3rd min (HI = 0.92) of recovery after the deficit test. In this study, the most relevant findings were: firstly, significant HI values for many of the variables studied; secondly, the HI values of the parameters used to evaluate explosive power were higher than those of lactic acid capacity and thirdly, the HI of certain variables from different tests measuring, in theory, similar qualities, were different.
Arbeitsphysiologie 01/2002; 86(3):218-25. · 2.15 Impact Factor
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ABSTRACT: The differences in ventilatory response to exercise of some highland ethnic communities is a controversial issue. We have evaluated the differences in ventilatory response to exercise at sea level between two groups of elite climbers, four Himalayan Sherpas (S) and four Caucasian lowlanders (C), after descent from extreme altitude. All of them performed a progressive-intensity exercise test on a treadmill under normoxic conditions. Pulmonary gas exchange was obtained until exhaustion by means of an automatic gas-analyzer system. Significant differences in expired ventilation and carbon dioxide production were found between the two groups, the e being lower in the S at rest (41.9±5) in comparison with C (48.7±9) (P<0.05), higher at medium loads of the test (S=28.2±4 vs. C=25.7±2; P<0.05) and reaching similar values at higher loads (S=34.5±2 vs. C=35.6±4; NS). We conclude that the special ventilatory response observed in these highlanders could explain their adaptation to altitude, allowing higher oxygen blood saturation at medium working loads and reducing the risk of neurological injury caused by a high ventilatory response when exercising at high intensity effort under extreme altitude environment.
Respiration Physiology 08/1998;
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ABSTRACT: Cardiopulmonary bypass (CPB) is a relatively common procedure in cardiac surgery. At the end, the heart is electrically defibrillated if not already beating. External and internal cardioversion by specific catheters do not raise plasma troponin concentration, but the possible repercussion on troponin of the direct cardioversion of the heart has not been documented.
Prospective comparative trial in a surgical intensive care unit in a university hospital was conducted. The study sample comprised 364 consecutive patients undergoing cardiac surgery with CPB and without perioperative myocardial infarction.
The number of cardioversions applied was recorded and three groups were obtained: A/no cardioversion; B/one or two cardioversions; and C/more than two cardioversions. Serum troponin I and CK-MB were determined at admission and after 6, 12, 24, and 48 hours. Significant differences were found between group C and groups A and B for troponin I and creatine kinase (CK-MB) curves, being higher for both variables in group C.
With more than two cardioversions post-CPB, both troponin I and CK-MB may present an additional increase.
Journal of Cardiac Surgery 22(3):192-4. · 0.87 Impact Factor
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ABSTRACT: Introducción y objetivos: El objetivo del estudio fue evaluar las diferencias en la concentración plasmática de cortisol tras la realización de un esfuerzo mixto, aeróbicoanaeróbico, en un grupo de jóvenes físicamente activos. Métodos: Catorce voluntarios realizaron, en un cicloergómetro, 40 min de ejercicio a la intensidad correspondiente al 50% del pico individual de consumo de oxígeno, manteniendo el ritmo de pedaleo a 60 revoluciones/min. Durante el mismo, se intercalaron 4 fases de 30 s con una carga de 0,04 kg por kilo de masa corporal en los minutos 10, 20, 30 y 40. Tras estos primeros minutos, pedaleaban durante 20 min a la máxima velocidad posible frente a una carga constante correspondiente al 50% del consumo de oxígeno. Se controlaron los parámetros cardiorrespiratorios y se recogieron muestras sanguíneas al inicio de la prueba, cada 10 min durante el ejercicio y a los 15 min de la recuperación. Resultados: Las respuestas cardiopulmonar y metabólica fueron muy homogéneas, con un aumento de los valores de cortisol a lo largo de la prueba (F = 5,16; p < 0,001) que presentó diferencias entre los sujetos (F = 6,74; p < 0,001). En 8 participantes (57,1% de la muestra) se observó un aumento, y en 6 (42,9%) los cambios fueron pequeños con respecto a los valores previos al inicio de la prueba. Conclusión: A pesar de haber evaluado un grupo homogéneo, se observaron diferencias interindividuales en la concentración plasmática de cortisol tras la realización de un esfuerzo mixto, lo que puede tener implicaciones en la adaptación provocada por el ejercicio.
Apunts. Medicina de l'esport; Vol.: 42 Núm.: 153.
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ABSTRACT: Introducció i objectius: L’objectiu de l’estudi va ser avaluar les diferències en la concentració plasmàtica de cortisol després de la realització d’un esforç mixt, aeròbic-anaeròbic, en un grup de joves físicament actius. Mètodes: Catorze voluntaris van fer, en un cicloergòmetre, 40 min d’exercici a la intensitat corresponent al 50% del consum màxim d’oxigen, mantenint el ritme de pedalada a 60 revolucions/min. I s’hi van intercalar 4 fases de 30 s amb una càrrega de 0,04 kg per quilo de massa corporal, en els minuts 10, 20, 30 i 40. Després d’aquests primers minuts, pedalaven durant 20 min a la màxima velocitat possible per una càrrega constant corresponent al 50% del consum màxim d’oxigen. Se’n van monitoritzar els paràmetres cardiorespiratoris, i se’n recolliren mostres sanguínies a l’inici de la prova, cada 10 min durant l’exercici i als 15 min de la recuperació. Resultats: Les respostes cardiopulmonar i metabòlica van ser molt homogènies, amb un augment dels valors de cortisol durant la prova (F = 5,16; p < 0,001), que van presentar diferències entre els subjectes (F = 6,74; p < 0,001). En 8 participants (57,1% de la mostra) es va observar un augment, i en 6 (42,9% de la mostra) els canvis van ser petits respecte dels valors previs a l’inici de la prova. Conclusió: Malgrat ser avaluat un grup homogeni, es van observar diferències interindividuals en la concentració plasmàtica de cortisol després de la realització d’un esforç mixt, que poden tenir implicacions en l’adaptació provocada per l’exercici.
Apunts. Medicina de l'esport; Vol.: 42 Núm.: 153.
