13 results

Scores TISS-28 versus NEMS to size the nursing team in a pediatric intensive care unit

Kelly Dayane Stochero Velozo, Pedro Celiny Ramos Garcia, Jefferson Pedro Piva, Humberto Holmer Fiori, Daiane Drescher Cabral, Paulo Roberto Einloft, [...]

DOI: 10.1590/S1679-45082017AO4028

ABSTRACT Objective: To estimate the workload and size the nursing team using the scales TISS-28 and NEMS in a pediatric intensive care unit. Methods: An observational prospective study with a quantitative approach was conducted at the pediatric intensive care unit of a university hospital from Jan 1st, 2009 to Dec 31st, 2009. All children who remained hospitalized for more than 8 hours were included, with length of stay of 4 hours in case of death. Clinical data were collected and […]

Ventilatory support and hospital stay after liver transplant in cirrhotic patients with hepatopulmonary syndrome

José Leonardo Faustini Pereira, Lucas Homercher Galant, Eduardo Garcia, Luis Henrique Telles da Rosa, Ajácio Bandeira de Mello Brandão, Cláudio Augusto Marroni

DOI: 10.1590/S1679-45082017AO4081

ABSTRACT Objective To compare mechanical ventilation time, need for non-invasive ventilation, length of intensive care unit stay, and hospital stay after liver transplant in cirrhotic patients with and with no diagnosis of hepatopulmonary syndrome. Methods This was a prospective cohort study with a convenience sample of 178 patients (92 with hepatopulmonary syndrome) who were diagnosed as alcoholic or hepatitis C virus cirrhosis. The statistical analysis included Kolmogorov-Smirnov test and Students t test. Data were analyzed using SPSS version 16.0, and […]

Spontaneous breathing test in the prediction of extubation failure in the pediatric population

Milena Siciliano Nascimento, Celso Moura Rebello, Luciana Assis Pires Andrade Vale, Érica Santos, Cristiane do Prado

DOI: 10.1590/S1679-45082017AO3913

ABSTRACT Objective To assess whether the spontaneous breathing test can predict the extubation failure in pediatric population. Methods A prospective and observational study that evaluated data of inpatients at the Pediatric Intensive Care Unit between May 2011 and August 2013, receiving mechanical ventilation for at least 24 hours followed by extubation. The patients were classified in two groups: Test Group, with patients extubated after spontaneous breathing test, and Control Group, with patients extubated without spontaneous breathing test. Results A total […]

Risk factors for mortality in ventilator-associated tracheobronchitis: a case-control study

Leonilda Giani Pontes, Fernando Gatti de Menezes, Priscila Gonçalves, Alexandra do Rosário Toniolo, Claudia Vallone Silva, Julia Yaeko Kawagoe, [...]

DOI: 10.1590/S1679-45082017AO3865

ABSTRACT Objective To describe the microbiological characteristics and to assess the risk factors for mortality of ventilator-associated tracheobronchitis in a case-control study of intensive care patients. Methods This case-control study was conducted over a 6-year period in a 40-bed medical-surgical intensive care unit in a tertiary care, private hospital in São Paulo, Brazil. Case patients were identified using the Nosocomial Infection Control Committee database. For the analysis of risk factors, matched control subjects were selected from the same institution at […]

Strategies for appropriate antibiotic use in intensive care unit

Camila Delfino Ribeiro da Silva, Moacyr Silva Júnior

DOI: 10.1590/S1679-45082015RW3145

The comsumption of antibiotics is high, mainly in intensive care units. Unfortunately, most are inappropriately used leading to increased multi-resistant bacteria. It is well known that initial empirical therapy with broad-spectrum antibiotics reduce mortality rates. However the prolonged and irrational use of antimicrobials may also increase the risk of toxicity, drug interactions and diarrhea due to Clostridium difficile. Some strategies to rational use of antimicrobial agents include avoiding colonization treatment, de-escalation, monitoring serum levels of the agents, appropriate duration of […]

Oral care and nosocomial pneumonia: a systematic review

Maria Carolina Nunes Vilela, Gustavo Zanna Ferreira, Paulo Sérgio da Silva Santos, Nathalie Pepe Medeiros de Rezende

DOI: 10.1590/S1679-45082015RW2980

To perform a systematic review of the literature on the control of oral biofilms and the incidence of nosocomial pneumonia, in addition to assessing and classifying studies as to the grade of recommendation and level of evidence. The review was based on PubMed, LILACS, and Scopus databases, from January 1st, 2000 until December 31st, 2012. Studies evaluating oral hygiene care related to nosocomial infections in patients hospitalized in intensive care units were selected according to the inclusion criteria. Full published […]

Should we treat fever in critically ill patients? A summary of the current evidence from three randomized controlled trials

Ary Serpa Neto, Victor Galvão Moura Pereira, Giancarlo Colombo, Farah Christina de la Cruz Scarin, Camila Menezes Souza Pessoa, Leonardo Lima Rocha

DOI: 10.1590/S1679-45082014RW2785

Fever is a nonspecific response to various types of infectious or non-infectious insult and its significance in disease remains an enigma. Our aim was to summarize the current evidence for the use of antipyretic therapy in critically ill patients. We performed systematic review and meta-analysis of publications from 1966 to 2013. The MEDLINE and CENTRAL databases were searched for studies on antipyresis in critically ill patients. The meta-analysis was limited to: randomized controlled trials; adult human critically ill patients; treatment […]

Adequacy of oxygenation parameters in elderly patients undergoing mechanical ventilation

Luana Petruccio Cabral Monteiro Guedes, Fabrício Costa Delfino, Flavia Perassa de Faria, Gislane Ferreira de Melo, Gustavo de Azevedo Carvalho

DOI: 10.1590/S1679-45082013000400011

Objective:To compare ideal PaO2 with PaO2 found, ideal PaO2/FiO2 of room air with the one found, and ideal FiO2 with FiO2 found in mechanically ventilated elderly patients.METHODS:Cross-sectional study that evaluated elderly mechanically ventilated patients for at least 72 hours and who underwent three subsequent blood gas analyses.RESULTS:The sample consisted of 48 elderly with mean age of 74.77±9.36 years. There was a significant difference between the ideal PaO2 and the one found (p

Serum soluble-Fas is a predictor of red blood cell transfusion in critically ill patients

Ilana Levy Korkes, Gustavo Schvartsman, Ilson Jorge Lizuka, Beata Marie Quinto, Maria Aparecida Dalboni, Maria Eugênia Canziani, [...]

DOI: 10.1590/S1679-45082013000400012

Objective:To investigate the relation between the need for red blood cell transfusion and serum levels of soluble-Fas, erythropoietin and inflammatory cytokines in critically ill patients with and without acute kidney injury.METHODS:We studied critically ill patients with acute kidney injury (n=30) and without acute kidney injury (n=13), end-stage renal disease patients on hemodialysis (n=25) and healthy subjects (n=21). Serum levels of soluble-Fas, erythropoietin, interleukin 6, interleukin 10, iron status, hemoglobin and hematocrit concentration were analyzed in all groups. The association between […]

Pandemic influenza A/H1N1: comparative analysis of microscopic lung histopathological findings

Roberta Marchiori, Carla Sakuma de Oliveira Bredt, Marcos Menezes Freitas de Campos, Fábio Negretti, Péricles Almeida Delfino Duarte

DOI: 10.1590/S1679-45082012000300009

Objective:To analyze the histopathological lung findings of four fatal cases of the 2009 H1N1 influenza pandemic and their correlation with clinical and epidemiological characteristics.METHODS:Descriptive data from medical records of four patients who died in the Intensive Care Unit of a university hospital in 2009. Nasopharyngeal aspirate specimens were collected from the patients and were analyzed by real-time polymerase chain reaction. Lung biopsy was performed post mortem; a score of intensity for pathological changes was applied.RESULTS:Three patients had positive real-time polymerase […]

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