Revista Brasileira de terapia intensiva
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To evaluate the medical decisions at end-of-life of patients admitted at HU/UFSC and to compare these decisions and the profile of patients who died in the intensive care unit (ICU) to those who died in medical (MW) and surgical wards (SW). ⋯ The profile of patients who died and medical decisions during the end-of-life process were different in the intensive care unit, clinical and surgical wards.
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Pulmonary artery catheter is frequently used to monitor patients during liver transplantation. Recently developed less invasive methods for estimating cardiac output and pulmonary capillary wedge pressure together with the failure of randomized studies to demonstrate reduced mortality in pulmonary artery catheter-monitored patients, has restricted its applicability. Pulmonary artery rupture by pulmonary artery catheter is a rare, but dangerous complication. ⋯ Complications from use of pulmonary artery catheter are infrequent, however, due to their clinical severity, can cause high morbidity and mortality. A decreased use of pulmonary artery catheter reduced the number of complications observed. New clinical studies comparing pulmonary artery catheter with non-invasive methods for pulmonary capillary wedge pressure measurement must be conducted in liver transplantation.
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Rev Bras Ter Intensiva · Jun 2009
Early detection strategy and mortality reduction in severe sepsis.
To evaluate the impact of implementing an institutional policy for detection of severe sepsis and septic shock. ⋯ The strategy used helped to identify early risk of sepsis and resulted in decreased mortality associated with severe sepsis and septic shock.
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Rev Bras Ter Intensiva · Jun 2009
Association of alveolar recruitment maneuvers and prone position in acute respiratory disease syndrome patients.
The acute respiratory distress syndrome is the clinical presentation of acute lung injury characterized by diffuse alveolar damage and development of non-cardiogenic pulmonary edema due to increased pulmonary alveolar-capillary membrane permeability. Alveolar recruitment maneuvers and prone position can be used in the treatment of acute respiratory distress syndrome. The objective of this review of literature was to identify possible benefits, indications, complications and care of the associated recruitment maneuvers and prone position for treatment of the acute respiratory distress syndrome. ⋯ Despite advances in the understanding of acute respiratory distress syndrome pathophysiology, mortality is still expressive. Alveolar recruitment maneuvers and prone position significantly contribute to treatment of acute respiratory distress syndrome patient aiming to improve oxygenation and minimizing complications of refractory hypoxemia and reduction of pulmonary compliance. However,as there are few studies in literature associating alveolar recruitment maneuvers and prone position for treatment of acute respiratory distress syndrome, additional research and evidences of clinical application are required.
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Rev Bras Ter Intensiva · Jun 2009
Outcome and characteristics of infants with acute viral bronchiolitis submitted to mechanical ventilation in a Brazilian pediatric intensive care.
To describe the characteristics and the outcome of infants with acute viral bronchiolitis submitted to mechanical ventilation. ⋯ The declining mortality in acute viral bronchiolitis is observed even in non developed regions, involving children with high rates of anemia and premature labor. The low mortality is associated with the maintenance of the lower airway obstructive pattern during the period on mechanical ventilation. The development of acute respiratory distress syndrome is associated with increased mortality and higher prevalence of complications, representing the actual challenge in the management of children with severe acute viral bronchiolitis.