Jornal de pediatria
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To review the current support and treatment strategies of the acute respiratory distress syndrome. ⋯ The last decade was marked by significant advances, such as the concept of protective ventilation for acute respiratory distress syndrome. The benefit of alternative strategies, such as high-frequency oscillatory ventilation, the use of surfactant and immunomodulators continue to be the target of study.
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In the modern pediatric intensive care unit (PICU) physicians are often faced with the need to interrupt life-sustaining treatment (LST) and to allow children to die when no further treatment options are available. Consequently, the importance of palliative care has been increasing in this context. The goal of this review is to provide intensivists with guidelines to allow PICU patients to have a more dignified and humane death. ⋯ A child's death following withdrawal of LST in the PICU can be humane and dignified if basic principles of palliative care are followed. This is especially important in an environment that is notorious for the use of complex technology and described by the general public as inhumane.
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Jornal de pediatria · Nov 2003
Review[Analgesia and sedation in emergency situations and in the pediatric intensive care unit].
To review the current strategies for use of sedatives and analgesics in emergency rooms and intensive care units. ⋯ The last decade was marked by significant advances in understanding pediatric pain. Treating intensive care unit-related pain and anxiety has clear benefits which may influence the course of disease.
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To review the most important aspects of the clinical presentation and treatment of children with cancer in intensive care units. ⋯ Many studies show that the use of intensive care therapy in children with cancer is not futile, with a reduction in mortality and improvement in the quality of life of these children in the medium and long terms.
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To introduce the notion of noninvasive mechanical ventilation as an alternative for invasive ventilation in children, describing advantages and disadvantages, indications, and the process of equipment installation. ⋯ Noninvasive ventilation is a less costly, efficient and simple to perform alternative in cases of respiratory failure without hemodynamic instability.