Revista Brasileira de terapia intensiva
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Rev Bras Ter Intensiva · Mar 2010
Comparison and effects of two different airway occlusion times during measurement of maximal inspiratory pressure in adult intensive care unit neurological patients.
To verify if the maximal inspiratory pressure values with 40 seconds occlusion time are greater than with the 20 seconds occlusion time, and the impacts on the following patient's physiological variables: respiratory rate, pulse oxygen saturation, heart rate and blood pressure, before and after the measurements. ⋯ The measurement of maximal inspiratory pressure using a longer occlusion (40 seconds) produced higher values, without triggering clinically significant stress according to the selected variables.
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Rev Bras Ter Intensiva · Mar 2010
Retirada do leito após a descontinuação da ventilação mecânica: há repercussão na mortalidade e no tempo de permanência na unidade de terapia intensiva?
To describe the withdrawal of the bed frequency in mechanic ventilation patients and its impact on mortality and length of stay in the intensive care unit. ⋯ Patients withdrawn of bed following mechanical ventilation discontinuation showed lower mortality. It is suggested that early intensive care unit mobilization and withdrawal of bed should be stimulated.
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Rev Bras Ter Intensiva · Mar 2010
Effects of manual hyperinflation maneuver associated with positive end expiratory pressure in patients within coronary artery bypass grafting.
To verify the effects of manual hyperinflation maneuver associated with positive end expiratory pressure in coronary artery bypass grafting patients. ⋯ The results show that the manual hyperinflation associated with positive end expiratory pressure maneuver trends to promote increased lung volumes and static compliance, however these findings require further confirmation.
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Post-traumatic stress disorder has been detected in patients after treatment in intensive care unit. The main goal of this study is to review the psychological aspects and therapeutic interventions on those patients after their treatment on intensive care unit. Thirty eight articles have been included. ⋯ High doses of opiates, symptoms caused by sedation or analgesia reduction and the use of lorazepam were related with the increase of delirium and delusional memory. The disorder sintomatology can be reduced with hydrocortisone administration, with daily sedation interruption. No other effectiveness psychological intervention study was found.
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Rev Bras Ter Intensiva · Mar 2010
Understanding the PIRO concept: from theory to clinical practice - part 2.
A sepsis staging system focused on predisposition, insult, host response and organ failure may provide a useful basis for risk stratification. Knowledge on interactions among predisposing factors, insult characteristics and host response might help us to improve our understanding on sepsis pathophysiology and allow more individual therapeutic approach. Recent clinical studies documented the clinical importance of PIRO approach for severity stratification in septic patients in intensive care unit, and also for specific conditions such as community acquired pneumonia and ventilator associated pneumonia , with a good performance for outcome prediction. In this review we describe how this new concept can be used in clinical practice and provide some insights on its usefulness to facilitate the stratification and potential for enrollment in clinical trials of sepsis therapies.