Banca de DEFESA: WILDBERG ALENCAR LIMA

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : WILDBERG ALENCAR LIMA
DATE: 25/01/2023
TIME: 08:30
LOCAL: Google Meeting
TITLE:

LABORATORY AND SYSTEMIC DISORDERS ASSOCIATED WITH PATIENTS WITH ACUTE MYELOID LEUKEMIA IN AN INTENSIVE CARE UNIT.

KEY WORDS:

Acute myeloid leukemia, Kidney injury, liver function, mortality.

PAGES: 148
BIG AREA: Ciências Biológicas
AREA: Bioquímica
SUMMARY:

Acute myeloid leukemia (AML) consists of a clonal, progressive and heterogeneous neoplasm, resulting from alteration of the hematopoietic stem cell, which leads to uncoordinated growth of undifferentiated cells, called myeloblasts. This mechanism of change leads to an increase in these immature cells in the bone marrow with suppression of normal hematopoietic activity and, consequently, replacement of younger medullary and blood cells with functional immaturity. Among the different types of leukemias, AML presents greater clinical severity and consequently ranks first in proportion of deaths; in Brazil between 2008 and 2017, the proportion was 36% The objective of this study was to investigate the profile of metabolic and systemic disorders associated with AML, in patients admitted to the intensive care unit (ICU) of HEMOPE, a reference hospital for diseases hematological. This work consisted of a cross-sectional retrospective study with data collection carried out in laboratory test files and medical records, including the general characteristics of patients in the period 2020 and 2021, during the period of stay in the ICU (from admission to discharge or death). The total population consisted of 37 patients, 56.7% male and 43.2% female, mean age 48.4 ± 15.4 years. The analyzed data showed the following profile: Increase, in relation to reference values, of the main markers of renal function (creatinine in 64,9% of the population and urea in 78,4% of the population) and liver function (ALT in 59.4% and AST in 67.6% of the population). Laboratory markers, electrolytes and total proteins, did not show high values. These results indicate the presence of renal and hepatic impairment that may be due to the chemotherapy regimen used for induction treatment in AML. Analysis of the death rate showed 75% mortality, but there was no significant difference between the death outcome group (GDO) and the survivors group (GS) in terms of age, gender, kidney damage, liver damage and dialysis. The GDO had greater use of mechanical ventilatory assistance (AVM) (96.1% and vasoactive pain (VAD) (73%) than the GS, differing statistically, while the GS had a longer hospital stay (16 days) than the than the GDO (5 days). In addition, a significant increase was observed on the day of outcome in the GDO in relation to the GS, for markers of renal function, blasts, bilirubin, calcium, chloride, Ht and Hb. The results found suggest a greater systemic impairment of the GDO patients. The analysis of the odds ratio (OR) of death showed that patients on AVM had an OR 112.5 times higher and those who needed to use vasoactive drugs, the OR was 7.2 times higher. acute kidney injury in patients with AML admitted to the ICU was 85% and the mortality rate in these patients was 80%. of mortality. the results of the present study can provide important information to help with the therapeutic management of patients with AML admitted to the ICU and suggest that AVM and use of vasoactive drugs are predictors of mortality.

COMMITTEE MEMBERS:
Presidente - 1130925 - VERA LUCIA DE MENEZES LIMA
Interno - 2069591 - LEUCIO DUARTE VIEIRA FILHO
Externa ao Programa - 2129721 - BIANKA SANTANA DOS SANTOS - UFPEExterna à Instituição - ANA PAULA SANTANNA DA SILVA
Externo à Instituição - CESAR AUGUSTO DA SILVA - UNIVASF