Revista Brasileira de terapia intensiva
-
Rev Bras Ter Intensiva · Mar 2012
Expiratory peak flow and respiratory system resistance in mechanically ventilated patients undergoing two different forms of manually assisted cough.
Mechanical ventilation is associated with retained airway secretions. Manually assisted cough contributes to the displacement of bronchial mucus, whereas positive end-expiratory pressure increases collateral ventilation and maintains airway patency. This study aimed to assess the effects of manually assisted cough, either alone or added to increased positive end-expiratory pressure and inspiratory time (optimized manually assisted cough), on the expiratory peak flow and respiratory system mechanics in mechanically ventilated patients. ⋯ Optimized manually assisted cough increases the expiratory peak flow in comparison with manually assisted cough; in addition, this procedure reduces respiratory system resistance.
-
Rev Bras Ter Intensiva · Mar 2012
The incidence of delirium in patients pretreated with statins who remain in an intensive care unit after cardiac surgery.
To determine the association between the preoperative administration of statins and postoperative delirium in a prospective cohort of patients undergoing cardiac surgery. ⋯ The use of preoperative statins is not correlated with postoperative delirium in patients undergoing cardiac surgery.
-
Rev Bras Ter Intensiva · Mar 2012
Positive end-expiratory pressure increases strain in patients with ALI/ARDS.
The objective of this study was to assess the effects of positive end-expiratory pressure on recruitment, cyclic recruitment and derecruitment and strain in patients with acute lung injury and acute respiratory distress syndrome using lung computed tomography. ⋯ While strain is an adverse effect of positive end-expiratory pressure, the decision use positive end-expiratory pressure with any patient should be balanced against the potential benefits of recruitment. Due to the small number of patients in this study, the present data should be treated as hypothesis generating and is not intended to limit the clinical application of a high level of positive end-expiratory pressure in patients with severe hypoxemia.
-
Rev Bras Ter Intensiva · Mar 2012
Late-onset sepsis in preterm children in a neonatal intensive care unit: a three-year analysis.
To evaluate the prevalence factors and etiologies associated with late neonatal sepsis in preterm neonates in a neonatal intensive care unit. ⋯ Late sepsis remains a concern because of its prevalence in intensive care units and because it increases the number of invasive procedures that preterm children usually undergo in these units. The authors emphasize the expanding role of Gram-negative bacteria in late-onset neonatal sepsis and the need for more efficient methods to identify confirmed sepsis.