Revista Brasileira de terapia intensiva
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Rev Bras Ter Intensiva · Sep 2012
Use of non-invasive ventilation in acute pulmonary edema and chronic obstructive pulmonary disease exacerbation in emergency medicine: predictors of failure.
This study analyzed acute respiratory failure caused by acute pulmonary edema, as well as chronic obstructive pulmonary disease exacerbation, that was treated with non-invasive mechanical ventilation to identify the factors that are associated with the success or failure non-invasive mechanical ventilation in urgent and emergency service. ⋯ Respiratory frequency >25 rpm, higher APACHE II scores, BiPAP use and chronic obstructive pulmonary disease diagnosis were associated with endotracheal intubation. Higher GCS and SpO2 values were associated with NIV success. Non-invasive mechanical ventilation can be used in emergency services in acute respiratory failure cases caused by acute pulmonary edema and chronic obstructive pulmonary disease exacerbation, but patients with variables related to a higher percentage of endotracheal intubation should be specially monitored.
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Given the inaccessibility of indirect calorimetry, intensive care units generally use predictive equations or recommendations that are established by international societies to determine energy expenditure. The aim of the present study was to compare the energy expenditure of critically ill patients, as determined using indirect calorimetry, to the values obtained using the Harris-Benedict equation. ⋯ The Harris-Benedict equation is inaccurate and tends to underestimate energy expenditure. In addition, the Harris-Benedict equation is associated with significant differences between the predicted and true energy expenditure at an individual level.
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Rev Bras Ter Intensiva · Sep 2012
Urinary electrolyte monitoring in critically ill patients: a preliminary observational study.
Intensive care unit survivors and non-survivors have distinct acid-base profiles. The kidney's regulation of urinary electrolytes and the urinary strong ion difference plays a major role in acid-base homeostasis. The aim of this study was to evaluate the potential utility of daily spot urinary electrolyte measurement in acid-base and renal function monitoring. ⋯ Daily assessment of spot urinary electrolytes and strong ion difference are useful components of acid-base and renal function evaluations in critically ill patients, having distinct profiles between intensive care unit survivors and non-survivors.
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Rev Bras Ter Intensiva · Sep 2012
Incidence and primary causes of unplanned extubation in a neonatal intensive care unit.
This study established the incidence and primary causes of unplanned extubation in newborns in the neonatal intensive care units of the Hospital Sofia Feldman, Belo Horizonte (Minas Gerais). ⋯ The incidence of unplanned extubation in the investigated neonatal intensive care units was low during the study period compared to previously reported data. Nevertheless, the assessment of the quality of procedures, the continuous follow-up of newborns, and the monitoring of the causes of extubation are required to further reduce this incidence.
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Rev Bras Ter Intensiva · Sep 2012
Nutritional support and outcomes in critically ill patients after one week in the intensive care unit.
This study evaluated the relationship between nutritional intake and protein and caloric requirements and observed clinical outcomes on the 7th day of intensive care unit stay. ⋯ The results did not establish that energy and protein intakes of greater or less than 60% of nutritional requirements were reliable dividers of clinical outcomes.