Duarte Péricles A D, Leichtweis Gustavo Elias, Andriolo Luiza, Delevatti Yasmim A, Jorge Amaury C, Fumagalli Andreia C, Santos Luiz Claudio, Miura Cecilia K, Saito Sergio K
Hospital do Câncer (UOPECCAN) and Hospital Universitário and Hospital São Lucas, Cascavel, PR, Brazil.
Hospital São Lucas, Cascavel, PR, Brazil.
Crit Care Res Pract. 2017;2017:8046240. doi: 10.1155/2017/8046240. Epub 2017 Jun 15.
Acute Atrial Fibrillation (AF) is common in critically ill patients, with significant morbidity and mortality; however, its incidence and severity in Intensive Care Units (ICUs) from low-income countries are poorly studied. Additionally, impact of vasoactive drugs on its incidence and severity is still not understood. This study aimed to assess epidemiology and risk factors for acute new-onset AF in critically ill adult patients and the role of vasoactive drugs.
Cohort performed in seven general ICUs (including cardiac surgery) in three cities in Paraná State (southern Brazil) for 45 days. Patients were followed until hospital discharge.
Among 430 patients evaluated, the incidence of acute new-onset AF was 11.2%. Patients with AF had higher ICU and hospital mortality. Vasoactive drugs use (norepinephrine and dobutamine) was correlated with higher incidence of AF and higher mortality in patients with AF; vasopressin (though used in few patients) had no effect on development of AF.
In general ICU patients, incidence of new-onset AF was 11.2% with a high impact on morbidity and mortality, particularly associated with the presence of Acute Renal Failure. The use of vasoactive drugs (norepinephrine and dobutamine) could lead to a higher incidence of new-onset AF-associated morbidity and mortality.
急性房颤在重症患者中很常见，具有较高的发病率和死亡率；然而，低收入国家重症监护病房（ICU）中其发病率和严重程度的研究较少。此外，血管活性药物对其发病率和严重程度的影响仍不清楚。本研究旨在评估成年重症患者急性新发房颤的流行病学和危险因素以及血管活性药物的作用。
在巴西南部巴拉那州三个城市的七个普通ICU（包括心脏外科）进行了为期45天的队列研究。对患者进行随访直至出院。
在430例接受评估的患者中，急性新发房颤的发生率为11.2%。房颤患者的ICU死亡率和医院死亡率更高。血管活性药物（去甲肾上腺素和多巴酚丁胺）的使用与房颤的较高发生率以及房颤患者的较高死亡率相关；血管加压素（尽管使用的患者较少）对房颤的发生没有影响。
在普通ICU患者中，新发房颤的发生率为11.2%，对发病率和死亡率有很大影响，尤其是与急性肾衰竭的存在有关。血管活性药物（去甲肾上腺素和多巴酚丁胺）的使用可能导致新发房颤相关的发病率和死亡率升高。
