Category: Neurology Introduction: Dementia is a syndrome characterized by cognitive and/or behavioral decline associated with significant functional impairment, predominantly affecting the population over 65 years of age. A subgroup of dementia syndromes has a more aggressive clinical course, leading to complete dependency within a few years, with Creutzfeldt-Jakob disease being the most predominant cause of rapidly progressive dementia.() Objectives: To present a clinical case, discuss the clinical presentation, diagnostic criteria, differential diagnoses, and the challenges of managing the case in […]

Category: Nefrology Introduction: Continuous Renal Replacement Therapy (CRRT) is essential for managing acute kidney injury (AKI) in critically ill patients.(–) However, the complexity of CRRT increases the risk of near-miss events-incidents that could cause harm but are intercepted before actual damage occurs.() This study investigates the incidence, risk factors, and outcomes of near-miss events during CRRT in a tertiary ICU setting. Methods: A retrospective cohort study was conducted over 24 months in the ICU of a tertiary care hospital. Data […]

Category: Pneumology Introduction: Optimal weaning from mechanical ventilation (MV) is crucial for neurologic patients, who often face challenges such as altered respiratory mechanics and neurogenic respiratory failure. However, the diversity in weaning protocols across neurologic conditions like traumatic brain injury (TBI), stroke, and neuromuscular disorders complicates effective management.(–) Objectives: This systematic review seeks to evaluate and synthesize existing research on weaning protocols and strategies for neurologic patients reliant on mechanical ventilation. The primary goal is to identify effective weaning practices, […]

Category: Pneumology Introduction: Lung ultrasound is a widely used tool in the ICU environment. However, the real effectiveness of using ultrasound to help wean patients off mechanical ventilation is still unknown, as it is still imprecise to assess the ideal time for extubation. Objective: To review the use of lung ultrasound as a predictor of weaning from artificial ventilation. Methods: This is a systematic review using the PICOS strategy, with searches carried out in the Pubmed, CENTRAL, LILACS, CINAHL and […]

Category: Pneumology Introduction In bedridden patients, the integrity of the respiratory system may be compromised, leading to increased secretions and airway obstruction, which can cause atelectasis, impaired ventilation, and prolonged hospital stay. Bronchial hygiene maneuvers are used to optimize secretion removal; however, their repercussion are not fully understood.() Including the behavior of static compliance of the respiratory system, peak airway pressure and airway resistance.() Objective: Analyze the effects of flow and oscillatory secretion removal maneuvers followed by airway suctioning compared […]

Category: Pneumology Introduction: Severe respiratory failure in Covid-19 often requires invasive mechanical ventilation.() However, many of these patients are initially managed with NIV and HFNC, postponing intubation.(,) Objectives: This study aims to identify whether there is a difference in the device used before intubation, as well as whether the time taken until invasive mechanical ventilation influences mortality. Methods: Retrospective cohort study with patients hospitalized between May 1, 2020 and May 1, 2021. Patients over 18 years old admitted to semi-intensive […]

Category: Pneumology Introduction: The evolution of care for critically ill patients has saved many lives around the world.() Nevertheless, the increased number of survivors of critically ill episodes has also given rise to a substantial and expanding population of chronically critically ill patients (CCIP) who rely on mechanical ventilation (MV) support and other intensive care therapies for an extended period of time.(–) The prolonged MV support and other prevalent conditions encountered during intensive care unit (ICU) hospitalization are associated with […]

Category: Pneumology Introduction: The use of interfaces for non-invasive ventilation (NIV) is of great importance in adult patients admitted to the intensive care unit (ICU). The choice of interface for NIV is crucial as it directly affects patient comfort, tolerance and effectiveness of therapy. Objectives: This systematic review and network meta-analysis compare the effectiveness of interfaces in the treatment of patients with exacerbated acute or chronic respiratory failure requiring NIV in the ICU. Methods: The last search was performed on […]

Category: Pneumology Introduction: Acute Respiratory Distress Syndrome (ARDS) remains a significant challenge in intensive care, with an incidence rate of approximately 10% among hospital admissions and a mortality rate reaching up to 35%. Effective management of ARDS critically depends on early diagnosis and the timely initiation of appropriate treatment strategies. Traditional diagnostic criteria, particularly imaging techniques, are often criticized for their low sensitivity and specificity, which impede early detection. The advent of lung ultrasound (LUS) offers a promising alternative, recognized […]

Category: Pneumology Introduction: The airways play an important role in warming and humidifying inspired gas. During inspiration under normal physiological conditions, the air in the upper airway is heated to 37°C and becomes fully saturated at approximately 44 mgH2O per liter. The air passage through the airways that goes from the nose to the terminal bronchioles needs to fulfill three essential functions: humidifying, filtering and warming the inspired air. The use of invasive respiratory mechanical ventilation through an endotracheal tube […]