Revista Brasileira de terapia intensiva
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Rev Bras Ter Intensiva · Jun 2010
Acute kidney injury in children: incidence and prognostic factors in critical ill patients.
Acute kidney injury is characterized by sudden and generally revertible renal function impairment involving inability to maintain homeostasis. In pediatrics, the main causes of acute kidney injury are sepsis, use of nephrotoxic drugs and renal ischemia in critically ill patients. The incidence of acute kidney injury in these patients ranges from 20 to 30%, resulting in increased morbid-mortality, a 40 to 90% rate. This study aimed to evaluate the incidence of acute kidney injury in intensive care unit patients, to categorize the severity of the acute kidney injury according to the Pediatric Risk, Injury, Failure, Loss, End-Stage (pRIFLE), examine the relationship between the acute kidney injury and severity using the Pediatric Index of Mortality (PIM) and to analyze outcome predictors. ⋯ Acute kidney injury is frequent in critically ill patients. Early diagnosis and prompt and appropriate therapy for each clinical aspect may change this condition's course and severity, and reduce the patients' morbidity and mortality.
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Obese patients seem to have worse outcomes and more complications during intensive care unit (ICU) stay. This study describes the clinical course, complications and prognostic factors of obese patients admitted to an intensive care unit compared to a control group of nonobese patients. ⋯ Obesity did not increase the mortality rate, but improved intensive care unit length of stay. The current prognostic scoring systems do not include BMI, possibly underestimating the risk of death, and other quality of care indexes in obese patients. New studies could be useful to clarify how body mass index impacts the mortality rate.
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The elderly population is increasing all over the world. The need of intensive care by the elderly is also increasing. There is a lack of studies investigating the risk factors for death among critically ill elderly patients. This study aims to investigate the factors associated with death in a population of critically ill elderly patients admitted to an intensive care unit in Brazil. ⋯ Mortality is high among critically ill elderly patients. Factors associated with death were age, coma, hypotension, respiratory failure and acute kidney injury.
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Rev Bras Ter Intensiva · Jun 2010
Spontaneous breathing trial evaluation in preterm newborns extubation.
Neonates mechanic ventilation weaning has become a major clinical challenge, and constitutes a large portion of neonatal intensive care units workload. The spontaneous breathing trial (SBT), performed immediately before extubation, can provide useful information on the patient's spontaneous breathing ability. This study aimed to assess the SBT effectiveness for extubation success prediction in mechanically ventilated preterm infants. ⋯ The significant association between SBT and extubation success may contribute for prediction of successful weaning in preterm infants.
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Rev Bras Ter Intensiva · Jun 2010
Orotracheal intubation: physicians knowledge assessment and clinical practices in intensive care units.
To assess the physicians knowledge on intubation techniques and to identify the common practices. ⋯ Physicians knowledge on orotracheal intubation in the intensive care unit is unsatisfactory, even among qualified professionals. It is necessary to check if the responses to the questionnaire and actual clinical practices agree.