Revista Brasileira de terapia intensiva
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Rev Bras Ter Intensiva · Apr 2013
ReviewUse of femoral vein catheters for the assessment of perfusion parameters.
The use of central venous oxygen saturation (SvcO2) and arterial lactate in the diagnosis of severe tissue hypoperfusion is well established, and the optimization of these parameters is currently under investigation, particularly in patients with severe sepsis/septic shock. However, the only place for deep venous puncture or the first choice for puncture is often the femoral vein. Although venous saturation obtained from blood sampling from this catheter, instead of SvcO2, has already been used in the diagnosis of severe tissue hypoperfusion, little is known about the accuracy of the results. ⋯ Few studies in the literature have evaluated the use of femoral venous oxygen saturation (SvfO2) or venous lactate. The results obtained thus far demonstrate no adequate agreement between SvfO2 and SvcO2, which limits the clinical use of SvfO2. However, the apparent strong correlation between arterial and peripheral and central venous lactate values suggests that venous lactate obtained from the femoral vein could eventually be used instead of arterial lactate, although there is insufficient evidence on which to base this procedure at this time.
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Rev Bras Ter Intensiva · Apr 2013
The performance of a rapid response team in the management of code yellow events at a university hospital.
To describe the epidemiological data of the clinical instability events in patients attended to by the rapid response team and to identify prognostic factors. ⋯ There are patients in critical condition that require expert intensive care in the regular ward unit hospital beds. The events that most frequently led to the code yellow activation were related to hemodynamic and respiratory support. The interventions performed indicate the need for a physician on the team. The situation of pent-up demand is associated with a higher mortality rate.
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Rev Bras Ter Intensiva · Apr 2013
Severe virus influenza A H1N1 related pneumonia and community-acquired pneumonia: differences in the evolution.
To analyze the clinical, laboratory and evolution data of patients with severe influenza A H1N1 pneumonia and compare the data with that of patients with severe community-acquired bacterial pneumonia. ⋯ Differences in the leukocyte count, C-reactive protein concentrations and oxygenation profiles may contribute to the diagnosis and prognosis of patients with severe influenza A H1N1 virus-related pneumonia and community-acquired pneumonia.
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Rev Bras Ter Intensiva · Apr 2013
Observational StudyEvaluation of functional independence after discharge from the intensive care unit.
1) To evaluate the functional independence measures immediately after discharge from an intensive care unit and to compare these values with the FIMs 30 days after that period. 2) To evaluate the possible associated risk factors. ⋯ Functional independence, as evaluated by the functional independence measure scale, was improved at 30 days after discharge from the intensive care unit, but it was not possible to define the potentially related factors.
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Rev Bras Ter Intensiva · Apr 2013
Acute kidney injury in critically ill patients with lung disease: kidney-lung crosstalk.
To examine the factors associated with acute kidney injury and outcome in patients with lung disease. ⋯ There was a higher mortality rate in the acute kidney injury group. Increased mortality was associated with mechanical ventilation, high PEEP, urea and need for dialysis. Further studies must be performed to better establish the relationship between kidney and lung injury and its impact on patient outcome.