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Vol. 29. Issue 6.
Pages 260-263 (August - September 1993)
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Vol. 29. Issue 6.
Pages 260-263 (August - September 1993)
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Arritmias postneumectomía
Postpneumectomy arrythmias
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A. Bravo Cerro, J. Pérez Bernal, A. Herruzo Avilés, F. Neira Reina, H. Navarro Cabrera, M. Torres Cansino, R. Arroyo Cotán-Pinto
Servicio de Cirugía Torácica y Servicio de Cuidados Intensivos. Hospital Universitario Virgen del Rocío. Sevilla
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Hemos estudiado la incidencia de arritmias durante el postoperatorio inmediato en UCI de 50 pacientes sometidos a una neumectomía reglada. El 40% de los postoperados presentaron arritmias. En 20 enfermos detectamos 25 episodios de arritmias, apareciendo en cinco de ellos dos tipos independientes de arritmias, siendo ventriculares un 12%. Fibrilación auricular, taquicardia y extrasístoles supraventriculares fueron las arritmias más frecuentes. El 26% de los pacientes presentaron taquicardia sinusal mantenida, sin motivo desencadenante aparente.

Cinco enfermos (10%) con edema pulmonar postneumectomía presentaron arritmias precozmente, asociándose con mayor mortalidad postoperatoria. El oxígeno en sangre arterial pre y postneumectomía y las pruebas funcionales respiratorias no han demostrado capacidad predictiva para la aparición de arritmias.

Encontramos una mayor incidencia de arritmias en relación con alteraciones hemodinámicas, balances positivos de líquidos y, sobre todo, cuando se habían practicado neumectomías intrapericárdicas.

The incidence of arrythmias during the immediate postoperative period in the ICU in 50 patients submitted to pneumectomy was studied with 40% of the cases presenting postoperative arrthmias. In 20 patients 25 episodes of arrythmias were detected being ventricular in 12%. The most frequent arrythmias were auricular fibrillation, tachycardia and supraventricular extrasystoles. Twenty-six percent presented sustained sinusal tachycardia with no apparent cause.

Five patients (10%) with postneumectomy pulmonar) edema presented early arrythmias associated to higher postoperative mortality. Arterial bood oxygen pre and post pneumectomy and functional respiratory tests showed no predictive capacity for the appearance of arrythmias.

A higher incidence of arrythmias was found related to specially to hemodynamic alterations, positive fluid balance and specially to performance of intrapericardial pneumectomies.

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Copyright © 1993. Sociedad Española de Neumología y Cirugía Torácica
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