Revista Brasileira de terapia intensiva
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Rev Bras Ter Intensiva · Mar 2010
Effects of manual hyperinflation maneuver associated with positive end expiratory pressure in patients within coronary artery bypass grafting.
To verify the effects of manual hyperinflation maneuver associated with positive end expiratory pressure in coronary artery bypass grafting patients. ⋯ The results show that the manual hyperinflation associated with positive end expiratory pressure maneuver trends to promote increased lung volumes and static compliance, however these findings require further confirmation.
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Rev Bras Ter Intensiva · Mar 2010
Understanding the PIRO concept: from theory to clinical practice - part 2.
A sepsis staging system focused on predisposition, insult, host response and organ failure may provide a useful basis for risk stratification. Knowledge on interactions among predisposing factors, insult characteristics and host response might help us to improve our understanding on sepsis pathophysiology and allow more individual therapeutic approach. Recent clinical studies documented the clinical importance of PIRO approach for severity stratification in septic patients in intensive care unit, and also for specific conditions such as community acquired pneumonia and ventilator associated pneumonia , with a good performance for outcome prediction. In this review we describe how this new concept can be used in clinical practice and provide some insights on its usefulness to facilitate the stratification and potential for enrollment in clinical trials of sepsis therapies.
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Rev Bras Ter Intensiva · Mar 2010
Comparison and effects of two different airway occlusion times during measurement of maximal inspiratory pressure in adult intensive care unit neurological patients.
To verify if the maximal inspiratory pressure values with 40 seconds occlusion time are greater than with the 20 seconds occlusion time, and the impacts on the following patient's physiological variables: respiratory rate, pulse oxygen saturation, heart rate and blood pressure, before and after the measurements. ⋯ The measurement of maximal inspiratory pressure using a longer occlusion (40 seconds) produced higher values, without triggering clinically significant stress according to the selected variables.
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This study aimed to review the literature addressing motor physical therapy for intensive care unit adult patients. A literature search was conducted in the databases, PubMed, MedLine (International Literature and Health), LILACS (Latin American and Caribbean Health Sciences) and Cochrane between 1995 and December 2008 using the keywords: physical therapy, mobilization and intensive care unit. For comparison purposes we selected randomized controlled trials and prospective studies, addressing the subject motor physical therapy for intensive care unit adult patients. ⋯ Early mobilization is a new area, with little evidence so far. However, recent studies have confirmed that mechanically ventilated patients mobilization is safe and feasible, reducing both the intensive care unit and hospital stay. However, more studies are warranted to identify the exercise type, duration, intensity and impact for of early motor therapy in specific groups of patients.
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To predict readmission in intensive care unit analyzing the first 24 hours data after intensive care unit admission. ⋯ Age, comorbidities and respiratory- and/or sepsis-related admission are associated with increased readmission risk in the studied sample.