Revista Brasileira de terapia intensiva
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Rev Bras Ter Intensiva · Jan 2014
Review[Assessment and treatment of hyperglycemia in critically ill patients].
Hyperglycemia is a commonly encountered issue in critically ill patients in the intensive care setting. The presence of hyperglycemia is associated with increased morbidity and mortality, regardless of the reason for admission (e.g., acute myocardial infarction, status post-cardiovascular surgery, stroke, sepsis). ⋯ In clinical practice, several aspects must be taken into account in the management of these patients, including blood glucose targets, history of diabetes mellitus, the route of nutrition (enteral or parenteral), and available monitoring equipment, which substantially increases the workload of providers involved in the patients' care. This review describes the epidemiology, pathophysiology, management, and monitoring of hyperglycemia in the critically ill adult patient.
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Rev Bras Ter Intensiva · Jan 2014
[Impact of hospitalization in an intensive care unit on range of motion of critically ill patients: a pilot study].
To evaluate the joint range of motion of critically ill patients during hospitalization in the intensive care unit. ⋯ There was a tendency towards decreased range of motion of large joints such as the ankle, knee and elbow during hospitalization in the intensive care unit.
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Rev Bras Ter Intensiva · Jan 2014
[Predictors of extubation failure and reintubation in newborn infants subjected to mechanical ventilation].
To identify risk factors for extubation failure and reintubation in newborn infants subjected to mechanical ventilation and to establish whether ventilation parameters and blood gas analysis behave as predictors of those outcomes. ⋯ Low five-minute Apgar scores, age at extubation, length of mechanical ventilation, acid-base disorders and hyperoxia exhibited associations with the investigated outcomes of extubation failure and reintubation.
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Rev Bras Ter Intensiva · Jan 2014
[Augmented renal clearance in critically ill patients: incidence, associated factors and effects on vancomycin treatment].
An augmented renal clearance has been described in some groups of critically ill patients, and it might induce sub-optimal concentrations of drugs eliminated by glomerular filtration, mainly antibiotics. Studies on its occurrence and determinants are lacking. Our goals were to determine the incidence and associated factors of augmented renal clearance and the effects on vancomycin concentrations and dosing in a series of intensive care unit patients. ⋯ In this cohort of critically ill patients, augmented renal clearance was a common finding. Age and absence of diabetes were the only independent determinants. Therefore, younger and previously healthy patients might require larger vancomycin dosing.
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Rev Bras Ter Intensiva · Jan 2014
[Performance of the Pediatric Index of Mortality 2 in a pediatric intensive care unit].
To assess the discrimination and calibration of the Pediatric Index of Mortality 2 in patients admitted to a pediatric intensive care unit. ⋯ Pediatric Index of Mortality 2 exhibited satisfactory performance.