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  • Predictors of acute kidney injury associated with cardiopulmonary bypass
    Publication . Moreira, Raquel; Jacinto, Tiago; Neves, Paulo; Vouga, Luís; Baeta, Cristina
    To study the incidence of acute kidney injury (AKI) in the postoperative period of cardiac surgery in patients without preoperative renal insufficiency who underwent cardiac surgery with cardiopulmonary bypass (CPB), and to explore the association between the incidence of AKI and predictors related to CPB. Observational, cross-sectional study. Participants were divided in two groups, those who developed AKI in the postoperative period and those who did not develop AKI. Kidney Disease: Improving Global Outcomes - Clinical Practice Guideline for Acute Kidney Injury (KDIGO) classification was used to characterize AKI. The analysis included preoperative variables (anthropometric data, cardiovascular risk factors and blood parameters), as well as the type of surgery, intraoperative variables related to CPB, and postoperative creatinine variation. Association between variables was studied with binary logistic regression. We have included 329 patients, of which 62 (19%), developed AKI. There were statistically significant differences between the groups in age (p<0.001; OR (95%)-1.075 (1.037-1.114)), duration of CPB (p=0.011; 1.008 (1.002-1.014)), urine output during CPB (p=0.038; 0.998 (0.996-0.999)), mannitol and furosemide administration during CPB, (respectively, p=0.032; 2.293 (1.075-4.890) and p=0.013; 2.535 (1.214-5.296)). A significant number of patients developed AKI in the postoperative period of cardiac surgery and this incidence was influenced by factors related to CPB, namely: age, duration of CPB, urine output during CPB, mannitol and furosemide administration during CPB.
    2021-05-26Journal article Open access Show more
  • Burnout in Portuguese physiotherapists during COVID-19 pandemic
    Publication . Jácome, Cristina; Seixas, Adérito; Serrão, Carla; Teixeira, Andreia; Castro, Luísa; Duarte, Ivone
    This study described the burnout experienced by physiotherapists during the COVID-19 pandemic and analysed the role of possible factors of this occupational phenomenon. Cross-sectional study based on a web-based survey applied to physiotherapists living in Portugal. The survey included sociodemographic, health status and clinical practice questions. The Copenhagen Burnout Inventory (personal, work- and patient-related burnout), the Resilience Scale, the Depression Anxiety and Stress Scales and the Satisfaction with Life Scale were used. A total of 511 physiotherapists (median 33 years old, 82% females) completed the survey. The participants worked mainly in private practice (50%) and wards (35%). During COVID-19, 52% were working directly with patients, but only 18% were working with COVID-19 patients. Personal (42%), work- (42%) and patient-related burnout (25%) was observed. Three significant models explained personal- (R2 = 51%), work- (R2 = 31%) and patient-related burnout (R2 = 16%). Lower levels of resilience and higher levels of depression and stress were significantly associated with personal, work- and patient-related burnout. Being female and working directly with patients were additionally associated with both personal and work-related burnout. Having health problems and working with COVID-19 patients were only associated with personal burnout. More than 40% of physiotherapists experienced personal and work-related burnout and 25% patient-related burnout, with resilience, depression and stress having a relevant role in the three burnout dimensions. Early detection and management strategies need to be implemented to address physiotherapists' physical and psychological fatigue and exhaustion.
    2021-05-26Journal article Open access Show more