Revista Brasileira de terapia intensiva
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The II Brazilian Consensus Conference on Mechanical Ventilation was published in 2000. Knowledge on the field of mechanical ventilation evolved rapidly since then, with the publication of numerous clinical studies with potential impact on the ventilatory management of critically ill patients. Moreover, the evolving concept of evidence - based medicine determined the grading of clinical recommendations according to the methodological value of the studies on which they are based. This explicit approach has broadened the understanding and adoption of clinical recommendations. For these reasons, AMIB - Associação de Medicina Intensiva Brasileira and SBPT - Sociedade Brasileira de Pneumologia e Tisiologia - decided to update the recommendations of the II Brazilian Consensus. Weaning from mechanical ventilation has been one of the updated topics. This objective was described the most important topics related to weaning from mechanical ventilation. ⋯ Weaning is a very important period of mechanical ventilatory support. Weaning protocols are recommended to select patients ready to be extubated.
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Rev Bras Ter Intensiva · Sep 2007
Agreement and correlation of pH, bicarbonate, base excess and lactate measurements in venous and arterial blood of premature and term infants.
Determine the extent of agreement and correlation between arterial samples and venous (obtained from a venous umbilical catheter), with respect to measurements of pH, bicarbonate, base excess and lactate, in critically ill term and premature newborns. ⋯ Although single venous values cannot be used as equivalent to arterial for assessing acid base status in newborns, venous blood samples can be used serially for monitoring trends over time.
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Rev Bras Ter Intensiva · Sep 2007
[Clonidine associated to morphine and midazolam in children submitted to mechanical ventilation: randomized, double blind and placebo controlled study].
In our country, the abstinence syndrome has high prevalence and besides the distress prolongs the length of hospital stay. The aim of this study was to evaluate the influence of associating oral clonidine to the intravenous morphine plus midazolam continuous infusion in children submitted to mechanical ventilation. ⋯ In children submitted to mechanical ventilation using high dose of opioids and diazepinic infusion the addiction of clonidine did not decrease the daily doses neither the cumulative doses and nevertheless reduced the prevalence and the evolution of abstinence syndrome.
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Rev Bras Ter Intensiva · Sep 2007
[Comparison among three methods to measure the rapid shallow breathing index in patients submitted to weaning from mechanical ventilation].
To compare the attainment of the rapid shallow breathing index (IRRS) in modalities PSV 10 cmH2O and PEEP 5 cmH2O (PSV10), CPAP 5 cmH2O (CPAP5) and spontaneous breathing (SB), correlating them with success on failure in the withdrawal of mechanical ventilation (MV). ⋯ From this sample, it can be observed that IRRS values are overestimated when gotten in modality PSV10. It was also evidenced that there is no need of a 30 min T-tube SB before extubation, when the weaning is performed with the technique of gradual reduction of PSV. This study suggested that IRRS is able to predict weaning success; however it is not able to determine failure when it was < 105. It is recommended that IRRS must be analyzed in association with other predictive weaning parameters.
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Rev Bras Ter Intensiva · Sep 2007
[Cuff leak test preextubation: comparison between three methods in spontaneous ventilation].
The cuff leak test aims to evaluate the presence of airway obstruction and normally is carried through in the controlled mode of mechanical ventilation. The objective of this study was to evaluate the cuff leak in patients breathing spontaneously, across three different methods, and to compare them. ⋯ The cuff leak test in spontaneous ventilation seems to be more accurate when the patient is connected to the mechanical ventilator, and that additional studies are needed to determine the real contribution of the test in this ventilation mode to predict laryngeal edema.