Rev Assoc Med Bras
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This article focused on verifying if hyperglycemia in critically ill pediatric patients is a risk factor for increased morbidity and mortality and carried out a critical analysis of the articles in pediatrics and neonatology. ⋯ Analysis of these cohort studies supported the conclusion that hyperglycemia, isolated or persistent during stay in PICU, increases morbidity, mortality and length-of-stay in PICU of critically ill children. However, these studies disclosed methodological issues such as lack of protocols for glucose measurement, design (most of them retrospective cohorts) and many articles did not confirm hyperglycemia as a single predictor of morbidity and mortality in pediatrics; therefore further prospective studies are necessary.
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Randomized Controlled Trial
Effects on mother and fetus of epidural and combined spinal-epidural techniques for labor analgesia.
Epidural (EA) and combined spinal-epidural (CSE) techniques have both been utilized for labor analgesia. This study compared the effects on the mother and newborn of these techniques in labor analgesia and anesthesia. ⋯ EA and CSE analgesia relieved maternal pain during obstetric analgesia, but CSE mothers had pruritus and a longer labor. Newborns of mothers who received epidural analgesia showed the best NACS.
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Controlled Clinical Trial
[Use of forced-air to prevent intraoperative hypothermia].
Hypothermia is a life-threatening event during the perioperative period. No consensus has been reached about the best active warming approach for such cases. Furthermore there is no consensus on the most appropriate time to warm a hypothermic patient. This study aimed to assess the efficacy of a forced-air blanket to warm patients at 38 degrees C before and during surgery. Following utilization of the forced-air blanket, adverse effects were evaluated. ⋯ The forced-air blanket is effective to prevent intraoperative hypothermia when applied for a period ranging from 30 min before anesthetic induction to 120 min after anesthetic induction. In the conditions of this study, adverse effects were not observed.
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Comparative Study
[APACHE II and ATN-ISS in acute renal failure (ARF) in intensive care unit (ICU) and non-ICU].
Acute renal failure (ARF) remains highly prevalent with a high rate of morbidity and mortality. ⋯ It was concluded that the APACHE II and ATN-ISS scores could be used for stratification of risk in patients with ARF treated outside of the ICU in Brazil.