Revista Brasileira de terapia intensiva
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Rev Bras Ter Intensiva · Dec 2009
Comparison between respiratory pulse oximetry plethysmographic waveform amplitude and arterial pulse pressure variations among patients with and without norepinephrine use.
Arterial pulse pressure respiratory variation is a good predictor of fluid response in ventilated patients. Recently, it was shown that respiratory variation in arterial pulse pressure correlates with variation in pulse oximetry plethysmographic waveform amplitude. We wanted to evaluate the correlation between respiratory variation in arterial pulse pressure and respiratory variation in pulse oximetry plethysmographic waveform amplitude, and to determine whether this correlation was influenced by norepinephrine administration. ⋯ Respiratory variation in arterial pulse pressure above 13% can be accurately predicted by a respiratory variation in pulse oximetry plethysmographic waveform amplitude of 14%. The use of norepinephrine does not alter this relationship.
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This study aimed to review the literature addressing motor physical therapy for intensive care unit adult patients. A literature search was conducted in the databases, PubMed, MedLine (International Literature and Health), LILACS (Latin American and Caribbean Health Sciences) and Cochrane between 1995 and December 2008 using the keywords: physical therapy, mobilization and intensive care unit. For comparison purposes we selected randomized controlled trials and prospective studies, addressing the subject motor physical therapy for intensive care unit adult patients. ⋯ Early mobilization is a new area, with little evidence so far. However, recent studies have confirmed that mechanically ventilated patients mobilization is safe and feasible, reducing both the intensive care unit and hospital stay. However, more studies are warranted to identify the exercise type, duration, intensity and impact for of early motor therapy in specific groups of patients.
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To predict readmission in intensive care unit analyzing the first 24 hours data after intensive care unit admission. ⋯ Age, comorbidities and respiratory- and/or sepsis-related admission are associated with increased readmission risk in the studied sample.
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Rev Bras Ter Intensiva · Dec 2009
Study of resuscitated in- and out-hospital cardiorespiratory arrest patients undergoing therapeutic hypothermia.
To determine the characteristics of patients undergoing standard institutional protocol for management of resuscitated patients after a cardiac arrest episode, including therapeutic hypothermia. ⋯ The creation of a standard operative protocol for therapeutic hypothermia in post cardiac arrest patients management resulted in a high use of therapeutic hypothermia. The clinical results of this protocol adapted from randomized studies are similar to the literature.
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Rev Bras Ter Intensiva · Dec 2009
Understanding the PIRO concept: from theory to clinical practice - Part 1.
Despite recent advances in diagnosis and care of critically ill patients sepsis related mortality rate remains unacceptably high. Therefore, new methods of evaluation are necessary to provide an earlier and more accurate characterization of septic patients. Based on the (oncologic) TNM system, the PIRO concept was introduced as a new staging system for sepsis in order to assess risk and predict prognosis, with potential to assist in inclusion of patients in clinical studies and estimate the probability of response of patients to specific therapeutic interventions.