Revista Brasileira de terapia intensiva
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Rev Bras Ter Intensiva · Jan 2015
Randomized Controlled Trial Multicenter StudyBlood transfusions in septic shock: is 7.0 g/dL really the appropriate threshold?
To evaluate the immediate effects of red blood cell transfusion on central venous oxygen saturation and lactate levels in septic shock patients with different transfusion triggers. ⋯ Red blood cell transfusion increased central venous oxygen saturation and decreased lactate levels in patients with hypoperfusion regardless of their baseline hemoglobin levels. Transfusion did not appear to impair these variables in patients without hypoperfusion. ClinicalTrials.gov NCT01611753.
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Rev Bras Ter Intensiva · Jan 2015
ReviewTherapeutic hypothermia as a bridge to transplantation in patients with fulminant hepatic failure.
The most important topics in fulminant hepatic failure are cerebral edema and intracranial hypertension. Among all therapeutic options, systemic induced hypothermia to 33 - 34ºC has been reported to reduce the high pressure and increase the time during which patients can tolerate a graft. This review discusses the indications and adverse effects of hypothermia.
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Rev Bras Ter Intensiva · Jan 2015
Multicenter StudyThe reality of patients requiring prolonged mechanical ventilation: a multicenter study.
The number of patients who require prolonged mechanical ventilation increased during the last decade, which generated a large population of chronically ill patients. This study established the incidence of prolonged mechanical ventilation in four intensive care units and reported different characteristics, hospital outcomes, and the impact of costs and services of prolonged mechanical ventilation patients (mechanical ventilation dependency ≥ 21 days) compared with non-prolonged mechanical ventilation patients (mechanical ventilation dependency < 21 days). ⋯ The classification of chronically critically ill patients according to the definition of prolonged mechanical ventilation adopted by our study (mechanical ventilation dependency ≥ 21 days) identified patients with a high risk for complications during intensive care unit stay, longer intensive care unit and hospital stays, high death rates, and higher costs.
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Rev Bras Ter Intensiva · Jan 2015
Swallowing rehabilitation of dysphagic tracheostomized patients under mechanical ventilation in intensive care units: a feasibility study.
The aim of the present study was to assess the feasibility of the early implementation of a swallowing rehabilitation program in tracheostomized patients under mechanical ventilation with dysphagia. ⋯ In this small group of patients, we demonstrated that the early implementation of a swallowing rehabilitation program is feasible even in patients under mechanical ventilation.
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Rev Bras Ter Intensiva · Jan 2015
Septic shock: a major cause of hospital death after intensive care unit discharge.
To assess the causes and factors associated with the death of patients between intensive care unit discharge and hospital discharge. ⋯ The main cause of death of patients who were discharged from the intensive care unit and died in the ward before hospital discharge was septic shock. Coverage by the public healthcare system and longer hospitalization time in the intensive care unit were factors associated with death after discharge from the intensive care unit.