Revista Brasileira de terapia intensiva
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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.
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Rev Bras Ter Intensiva · Mar 2010
Effects of motor physical therapy in critically ill patients: literature review.
The development of critical patient-related generalized weakness is a common complication in patients admitted to an intensive care unit. The reduced muscle strength increases the time for weaning, hospitalization, the risk of infections and consequent mortality. ⋯ Literature searches were performed using the electronic databases Medline, LILACS, CINAHL, Cochrane, High Wire Press and SciELO, from January 1998 to July 2009 and book chapters, using keywords including "critical illness", "cinesiotherapy", "physical therapy", "physiotherapy", "exercises", "training", "force", "active mobilization", "mobilization", "ICU", "rehabilitation", "mobility", "muscle strength" and "weakness". Despite the lack of studies and methodological diversity of studies found, confirming the use of exercise alone as a therapeutic resource, its use, including early seems an alternative to prevent and reverse muscle weakness intensive care unit ICU-acquired.
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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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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.