Repercussões clínico-hemodinâmicas no pós-operatório de lipoaspiração úmida.

AUTOR(ES)

João Cantarelli Filho

DATA DE PUBLICAÇÃO

2009

RESUMO

Hypovolemia is a hemodynamic disorder occasionally associated with liposuction. The purpose of this study is to settle a safety limit for the volume of aspirate in wet liposuction relating this volume to body weight. The criteria used to establish this limit were based on the ATLS (Advanced Trauma Life Support). Casuistic and Method: Thirty patients underwent wet liposuction and were submitted postoperatively to a 24-hour noninvasive monitoring control of hemodynamic signs. Tachycardia (over 100 bpm) and systolic hypotension (below 100 mmHg) were recorded as well as urinary volume and respiratory rate. Hemoglobin, hematocrit and leukocyte counts were determined preoperatively and also determined 1 and 6 hours postoperatively. Results: The volume of aspirate ranged from 1,480 to 3,980 ml (2.6 percent to 6.9 percent of body weight). Hemoglobin count decreased around 6 hours postoperatively as compared to the immediate preoperative period (range: 12.80.8 g/dl to 9.11.5 g/dl) (p<0.0001). An increase of leucocytes was observed around 6 hours postoperatively when compared with the preoperative period nearly 30 minutes before surgery (6,3531,849/mm to 11,9803,267/mm) p<0.0001). No association was found between hemoglobin or leukocyte counts and volume of aspirate. In 15 patients, tachycardia and/or hypotension were recorded postoperatively. These hemodynamic disorders were associated to volumes of aspirate higher than 5 percent of body weight. Conclusions: In wet liposuction a volume of aspiration not superior to 5 percent of body weight is proposed as a secure limit in surgical intervention of this type. It has been found as a clue to avoid hypovolemia and subsequently the shock. This is in agreement with ATLS guidelines.

ASSUNTO(S)

tachycardia postoperatorio period lipctomia cirurgia plastica e restauradora postoperative volume of aspirate wet liposuction lipoaspiração periodo pós-operatorio taquicardia lipectomy pós-operatório hypovolemia volume aspirado hipovolemia

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