Revista Brasileira de terapia intensiva
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Rev Bras Ter Intensiva · Apr 2018
ReviewDifficult decisions in pediatric practice and moral distress in the intensive care unit.
In an ethical dilemma, there is always an option that can be identified as the best one to be chosen. When it is impossible to adopt such option, the situation can lead professionals to experience moral distress. This review aims to define the issue of moral distress and propose coping strategies. ⋯ In clinical practice, health professionals need to be recognized as moral agents, and the development of moral courage was considered helpful to overcome ethical dilemmas and interprofessional conflicts. Both in pediatric and adult intensive care, professionals are challenged by questions about their practice, and they may experience moral distress. This suffering can be minimized and solved by understanding that the focus is always on the patient and acting with moral courage and good communication in an environment of mutual respect.
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Rev Bras Ter Intensiva · Apr 2018
Translation and cross-cultural adaptation of the Cornell Assessment of Pediatric Delirium scale for the Portuguese language.
This study sought to translate the Cornell Assessment of Pediatric Delirium from English into Brazilian Portuguese and cross-culturally adapt it for use in Brazil. ⋯ The translation of the Cornell Assessment of Pediatric Delirium into Brazilian Portuguese and its cross-cultural adaptation were successful and preserved the linguistic and semantic properties of the original instrument. The Cornell Assessment of Pediatric Delirium proved to be easy to understand and could be completed quickly. Additional studies are needed to test the validity and psychometric properties of this version in Brazil.
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Rev Bras Ter Intensiva · Apr 2018
Perfusion index for assessing microvascular reactivity in septic shock after fluid resuscitation.
Microcirculation disturbances are implicated in the prognosis of septic shock. Microvascular hyporesponsiveness can be assessed by an oximetry-derived perfusion index and reactive hyperemia. Using this perfusion index, we investigated reactive hyperemia and its relationship with peripheral perfusion and clinical-hemodynamic parameters in septic shock. ⋯ This perfusion index-based study suggests that septic shock promotes initial peripheral vascular hyporesponsiveness and preserves posterior vascular reactivity to a considerable degree. These results demonstrate a time-dependent peripheral hyperemic response and a significant ischemic reserve in septic shock.
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Rev Bras Ter Intensiva · Apr 2018
Assessment of the neuropsychomotor development in the first year of life of premature infants with and without bronchopulmonary dysplasia.
To compare the neuropsychomotor development in the first year of life of premature infants with and without bronchopulmonary dysplasia. ⋯ Bronchopulmonary dysplasia associated with other pre- and postnatal factors may be considered a risk factor for delayed neuropsychomotor development in the first year of life in premature infants born weighing less than 1,500g.