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: Safety/Quality/Management Introduction: Proper care for venous catheters is essential in managing critically ill patients, assessing clinical needs, duration of access, and specific patient conditions.() Certain tools can be used to make well-informed, evidence-based choices as part of safe, harm-free and minimally invasive care practices. The Michigan Appropriateness Guide for Intravenous Access (MAGIC®).() and the Venous Access Device (VAD) Expert® were used in this study. Objectives: Compare recommendations provided under the MAGIC® and DAV Expert® algorithms as part of decision-making […]

Category: Safety/Quality/Management Introduction: Patient safety is characterized as a series of actions aimed at preventing and minimizing harm or potential complications associated with healthcare practices.() Health care education is an important tool in promoting patient safety since it aims to raise individual and collective awareness among professionals that completed their studies or are currently undergoing training. Information and Communication Technologies have allowed professionals to disseminate content for educational purposes, as well as provided for self-learning via the Internet, thereby reinforcing […]

Category: Safety/Quality/Management Introduction: Inadequate allocation of critically ill patients in hospital settings poses significant challenges, potentially leading to suboptimal care, increased complications, and higher mortality rates. Factors such as ICU bed availability, variability in acuity assessment, and communication gaps among healthcare teams contribute to delays or inappropriate placement of patients in general wards or stepdown units.(–) Objective: This systematic review examines the implications of inadequate allocation of critically ill patients to wards or stepdown units. It analyzes contributing factors, clinical […]

Category: Safety/Quality/Management Introduction: Invasive mechanical ventilation (IMV) is the most widely used vital medical support worldwide in a diverse context of indications, such as: medical treatment of severe respiratory failure conditions, trauma, elective surgical procedures, among others.(,) However, adequate management by the multidisciplinary team is essential to achieve the goal set out in the therapeutic plan, the guarantee of operational efficiency, the rational use of the resource, and the prevention of adverse events, especially episodes of infection. Thus, a discussion […]

Category: Safety/Quality/Management Introduction: The protocolized care for patients with severe hemorrhage has proven to be a determining factor in reducing morbidity and mortality among hospitalized patients. The primary mechanism leading to death in this population is the state of shock resulting from this situation. Based on this information and an existing protocol in a private hospital of the Einstein Network, the H code was adapted and implemented in the Hospital Municipal Dr. Moysés Deutsch, which is part of the secondary […]

Category: Safety/Quality/Management Introduction: Efficient management of daily goals is strategic for tracking quality and communication of care in the Intensive Care Unit (ICU).() In the dynamic and complex environment of the ICU, clear coordination of conduct among members of the multidisciplinary teams is essential to ensure the direction of the therapeutic plan, efficiency of care, and team satisfaction.(,) Thus, a tool for monitoring team adherence to daily goals can contribute to better hospital outcomes. Objective: To develop and implement a […]

Category: Safety/Quality/Management Introduction: Modern healthcare systems demand innovative solutions to enhancecare quality and streamline hospital management. Artificial intelligence (AI) platforms, integrating complex data from various hospital systems, offer promising tools toaddress these challenges.(,) This study evaluates the impact of implementing the QlinkAI platform in a private hospital in São Paulo’s interior, aiming to improve patient safety, elevate care standards, and enhance operational efficiency. Detailed analysis includes assessing reductions in hospital infections, improvement in diagnostic accuracy, and enhanced interdepartmental communication. This […]

Category: Safety/Quality/Management Introduction: The use of simulation within medical education is already a reality. Currently many articles describe the various modes and the impacts self-reported by students. Within cardiology it is no different, but reviews on the subject do not direct to a single area. Objective: To review the effects of using simulation for medical education, specifically within cardiology. Methods: This is a systematic review according to PRISMA guidelines, using the Ovid MEDLINE, LILACS, CINAHL and CENTRAL databases. Clinical trials […]

Category: Nutrition/Metabolism Introduction: According to the National Cancer Institute, 704 thousand new cases of cancer are expected in Brazil for each year of the 2023-2025 triennium.() Malnutrition in cancer patients is common and largely multifactorial due to the direct and indirect effects of the tumor, treatments performed and psychological factors.() Objective: To verify whether, in patients admitted to the ICU, a protein intake target of 2.0g/kg/day compared to a conservative protein intake target of 1.5g/kg/day may be associated with kidney […]

Category: Neurology Introduction: Post-cardiac arrest syndrome often involves significant neurological injury, necessitating early and accurate cerebral perfusion assessment to optimize patient management and prognostication. Transcranial Doppler (TCD) offers a non-invasive method for monitoring cerebral blood flow velocities, potentially aiding in the early detection of neurological impairment and guiding therapeutic interventions. Methods: A systematic search of PubMed, Scopus, and the Cochrane Library was conducted using keywords such as “transcranial Doppler,” “cardiac arrest,” and “neurological outcome.” Studies were included if they assessed […]

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: Pneumology Introduction: Pulmonary neoplasms represent one of the most prevalent types of malignant tumors. In some cases, treatment requires complex thoracic surgeries, including the use of Venovenous Extracorporeal Membrane Oxygenation (VV ECMO), a pulmonary support technique used in patients with severe respiratory problems.(–) To aid in the recovery of these patients, physiotherapy plays a critical role, especially in cases of difficult ventilator weaning caused by loss of muscle strength. Objective: To describe the individualized physiotherapy strategies used to promote […]

Category: Pneumology Introduction: Lung Ultrasound (LUS) is a complementary imaging method utilized alongside clinical examination for the etiological identification of acute respiratory failure (ARF). It assists physicians in the differential diagnosis of conditions such as pneumothorax, pneumonia, pulmonary embolism, pulmonary edema, asthma, and Chronic Obstructive Pulmonary Disease (COPD) in patients with dyspnea in emergency departments. The advantage of LUS is that it can be performed bedside without exposing the patient to radiation, and it requires only one trained professional.(–) Methods: […]

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 […]

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 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: 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 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: 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 […]